Evidence map›Paper›PMID 40178687›Full record

ArticleEuropean journal of orthopaedic surgery & traumatology : orthopedie traumatologie2025

Osteonecrosis of the femoral head: treatment before the collapse. Experience with decompression and biological therapy.

Yuri Lara-Taranchenko, Iñaki Mimendia, Víctor Barro, María Guzmám, Margalida Hernández, Andrés Aliaga-Martínez, Diego Soza, Diego Collado, Ernesto Guerra Farfán, Alejandro Hernández

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Article in European journal of orthopaedic surgery & traumatology : orthopedie traumatologie, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
–field-weighted citation impact
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

2 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
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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

10 authors.

Yuri Lara-TaranchenkoHospital Universitario Vall d'Hebron, Barcelona, Spain. yuri.lara93@gmail.com.
Iñaki MimendiaHospital Universitario Vall d'Hebron, Barcelona, Spain.
Víctor BarroHospital Universitario Vall d'Hebron, Barcelona, Spain.
María GuzmámHospital Universitario Vall d'Hebron, Barcelona, Spain.
Margalida HernándezHospital Universitario Vall d'Hebron, Barcelona, Spain.
Andrés Aliaga-MartínezHospital Universitario Vall d'Hebron, Barcelona, Spain.
Diego SozaHospital Universitario Vall d'Hebron, Barcelona, Spain.
Diego ColladoHospital Universitario Vall d'Hebron, Barcelona, Spain.
Ernesto Guerra FarfánHospital Universitario Vall d'Hebron, Barcelona, Spain.
Alejandro HernándezHospital Universitario Vall d'Hebron, Barcelona, Spain.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionOsteonecrosis is a disabling condition and one of the most frequent causes of hip arthroplasty in the young population. Early detection and treatment in stages prior to femoral head collapse are essential to prevent progression and conversion to total hip arthroplasty (THA). The present study aims to demonstrate the results obtained in the treatment of patients with initial stages of ONFH, treated with a decompression system that associates biologic therapy (platelet-rich plasma and mesenchymal stem cells) (PERFUSE). METHODOLOGY: Retrospective unicentric study, in which all patients with ONFH treated with decompression of the necrotic area and biological therapy between May 2018 and May 2023, was collected. Demographic data of the patients (age and gender), risk factors for AVN, area of necrosis (Kerboul), ARCO classification, collapse rate, and conversion to THA were obtained.

resultsTwenty-four patients with ONFH were treated using the PERFUSE system. The mean age was 47.67 years old, and the mean follow-up was 26.1 months. The mean improvement in the modified Harris Hip Score (mHHS) was 10.11 (from 70.79 to 80.56; p = 0.018). Patients who developed femoral head collapse had worse mHHS scores. Six patients (25%) progressed to femoral head collapse, of which 2 (8.33%) were converted to total hip arthroplasty (THA). The probability of collapse-free survival at 12 months was 90.9% (SD 6.2; 95%CI, 79.5%-100%), and at 18 months, it was 85.2% (SD 8.0; 95%CI, 70.9%-100%), and at 24 months, it was 65.7% (SD 11.7; 95%CI, 46.3%-93.2%).

conclusionCore decompression with bone aspirate marrow and platelet-rich plasma can enhance bone regeneration and delay femoral head collapse, especially when implemented in early-stage ONFH. In this sense, combining both, core decompression with biological support can offer a promising approach for managing early-stage ONFH. Despite encouraging outcomes, further research is needed to optimize treatment protocols and evaluate long-term efficacy.

Indexed as

Decompression, SurgicalFemur Head NecrosisMesenchymal Stem Cell TransplantationPlatelet-Rich PlasmaAdultArthroplasty, Replacement, HipDisease ProgressionFemaleFemur HeadHumansMaleMiddle AgedRetrospective StudiesTreatment OutcomeBiological therapyCollapseDecompressionOsteonecrosis of the femoral headTotal hip arthroplasty

Identifiers

PMID40178687

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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.