Evidence map›Paper›PMID 33547484›Full record

ArticleInternational orthopaedics2021

Core decompression with autologous bone marrow aspirate injection in humeral head osteonecrosis in adults with sickle cell disease.

Gilles Guerin, Anoosha Habibi, Philippe Hernigou, Sebastien Zilber

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Article in International orthopaedics, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
1.1field-weighted citation impact, top 28% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 8 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors at 3 institutions in 2 countries.

Gilles GuerinDepartment of orthopedic surgery, APHP, Henri Mondor teaching hospital, 51 avenue du Marechal de Lattre de Tassigny, 94010, Creteil, France.
Anoosha HabibiSickle cell referral center, UPEC, Institut Mondor Recherche Biomédical (IMRB), Institut national de la Santé et de la Recherche médicale (INSERM) U955, APHP, Henri Mondor teaching hospital, DHU A-TVB, 94010, Creteil, France.
Philippe HernigouDepartment of orthopedic surgery, APHP, Henri Mondor teaching hospital, Creteil, France.
Sebastien ZilberAlmaviva Santé, Clinique Arago, Paris, France. sebastien.zilber@wanadoo.fr.ORCID http://orcid.org/0000-0002-8777-7079
Centre Hospitalier Universitaire Henri-Mondor · FRInserm · FRSeoil University · KR

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeSickle cell disease is often associated with osteonecrosis of the humeral head with a risk of progression to humeral head collapse. The aim of this study was to evaluate the clinical outcome and the effect on the necrosis evolution of humeral head core decompression with autologous bone marrow aspirate injection in these patients.

methodsForty shoulders in 23 patients were treated with core decompression with autologous concentrated iliac crest bone marrow aspirate injection. Patients were followed for a minimum of two  years (limits from 2 to 10 years). Functional outcomes metrics included the simple shoulder test (STT) and subjective shoulder value (SSV) as well as assessment of radiographic progression of disease.

resultsShoulder function improved significantly at final follow-up. The STT improved by 2.9 points (p = 0.001) and the SVV improved by 15 % (p = 0.001). However, based on radiologic features, the intervention did not halt the radiographic progression of disease nor did it result in healing of the lesion. The benefits were mainly clinical with diminished pain and functional improvement.

conclusionImprovement in shoulder function was observed following core decompression and bone marrow aspirate injection in patients with sickle cell disease and early humeral head necrosis stages. The procedure should not be considered for grade 3 or greater disease and for asymptomatic cases whatever the grade. Given the lack of radiographic improvement observed in this study, further study in the context of prospective controlled trials should be undertaken before this intervention can be widely recommended.

Indexed as

Anemia, Sickle CellFemur Head NecrosisOsteonecrosisAdultBone MarrowDecompression, SurgicalHumansHumeral HeadProspective StudiesTransplantation, AutologousTreatment OutcomeCore decompressionOsteonecrosisSickle cell diseaseStem cell

Identifiers

PMID33547484
OpenAlexW3128327040

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.