Hyperbaric oxygen for stage I and II femoral head osteonecrosis.

Abstract	Hyperbaric oxygen therapy is a suggested joint-preserving treatment for symptomatic early-stage osteonecrosis of the femoral head. Limited studies of this treatment have been published. The goal of this study was to evaluate the effectiveness of this treatment in a relatively large patient cohort. The authors reviewed the files of 68 patients with 78 symptomatic joints with Steinberg stage I and II osteonecrosis of the femoral head. All patients were treated with hyperbaric oxygen at the authors' medical health center. Pretreatment and immediate posttreatment magnetic resonance imaging (MRI) findings were compared. On follow-up, a telephone interview was conducted to determine the survival of the joint. Modified Harris Hip Score and Short Form 12 health survey (SF-12) questionnaires of the start of treatment and at follow-up were obtained and evaluated for statistically significant differences. Half of the joints were stage 1 and half were stage II. Seventy-four joints underwent both pre- and posttreatment MRI. Eighty-eight percent of joints showed improvement posttreatment. On follow-up at a mean of 11.1±5.1 years, 54 patients (58 joints) were located and answered the questionnaires. At the time of follow-up, 93% of the joints survived. Mean Harris Hip Score improved from 21 to 81 (P<.0001), the mean physical component of the SF-12 improved from 24 to 46 (P<.0001), and the mean mental component of the SF-12 improved from 54 to 59 (P<.0001). The authors concluded that hyperbaric oxygen treatment is effective in preserving the hip joint in stage I and II osteonecrosis of the femoral head.
Authors	Lior Koren, Eyal Ginesin, Yehuda Melamed, Doron Norman, Daniel Levin, Eli Peled
Journal	Orthopedics (Orthopedics) Vol. 38 Issue 3 Pg. e200-5 (Mar 2015) ISSN: 1938-2367 [Electronic] United States
PMID	25760507 (Publication Type: Journal Article)
Copyright	Copyright 2015, SLACK Incorporated.
Topics	Adult Cohort Studies Female Femur Head (pathology) Femur Head Necrosis (classification, therapy) Humans Hyperbaric Oxygenation Magnetic Resonance Imaging Male Middle Aged Retrospective Studies Treatment Outcome

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