Clinical effect of hyperbaric oxygen therapy in the treatment of femoral head necrosis

Li, Wei; Ye, Ziliang; Wang, Wei; Wang, Kun; Li, Lang; Zhao, Dewei

doi:10.1007/s00132-016-3360-8

Cited by 19 publications

(17 citation statements)

References 37 publications

(35 reference statements)

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“…These effects can explain the resolution of edema seen in radiological imaging and the relief of AVN symptoms by decreasing the bone internal pressure, restoring venous return, and improving microcirculation [26]. Furthermore, HBO can promote the viability and activity of the phagocytic cells which are beneficial to the absorption and removal of necrotic bone tissue [27].…”

Section: Discussionmentioning

confidence: 99%

Short-Term Outcome and MRI Changes in Three Adult Patients with Sickle Cell Disease and Aseptic Osteonecrosis after Treatment with Hyperbaric Oxygen Therapy: A Preliminary Report

et al. 2020

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Background: Musculoskeletal manifestations are common in sickle cell disease (SCD). Vasoocclusive crisis can manifest acutely as joint and bone pain, osteomyelitis and/or arthritis. It can also lead to chronic bone aches, bone deformities, degenerative arthritis, pathological fractures, and osteoporosis. Hyperbaric oxygen (HBO) therapy is a mode of treatment in which Case Shier et al.: Short-Term Outcome and MRI Changes in Three Adult Patients with SCD and Aseptic ON after Treatment with HBO Therapy 366the patient is exposed to very high arterial and tissue oxygen pressure, during multiple sessions. It has been used as primary or adjunctive therapy for a variety of medical disorders, including necrotizing infection and sickle cell crisis. Case Report: In this case series, 3 patients with SCD and avascular necrosis were treated with 15-40 sessions of HBO and were assessed 6-12 months by MRI after treatment. They showed different clinical outcomes and MRI changes. Conclusion: We concluded that HBO can result in some subjective improvement, especially in early stages. Further studies on severe cases are needed.

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Section: Discussionmentioning

confidence: 99%

Short-Term Outcome and MRI Changes in Three Adult Patients with Sickle Cell Disease and Aseptic Osteonecrosis after Treatment with Hyperbaric Oxygen Therapy: A Preliminary Report

et al. 2020

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“…HBO has been widely used in clinics due to its economical, convenient, and reusable properties, and it has also been preliminarily applied in pain treatment. 19 The CCI model is commonly used in pain studies. This model has a high repeatability, and the early shortening of thermal latency as well as the decrease of mechanical pain threshold is similar to the clinical features of NP in terms of peripheral and central pain sensitization.…”

Section: Discussionmentioning

confidence: 99%

The analgesic effect of early hyperbaric oxygen treatment in chronic constriction injury rats and its influence on nNOS and iNOS expression and inflammatory factor production

et al. 2018

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ObjectiveTo observe the analgesic effect of early hyperbaric oxygen (HBO) treatment in chronic constriction injury (CCI) rats, and to analyze the influence of HBO on the expression of neuronal nitric oxide synthase and inducible nitric oxide synthase and on the levels of inflammatory factors.MethodsRats were assigned into three groups randomly: sham, CCI, and HBO groups. The CCI rat model was established, and HBO treatment at 2.5 ATA (60 min) was given one day after surgery, lasting for five consecutive days. The pain behaviors of the rats were observed at predetermined time points, and the activation of astrocytes at dorsal horns as well as the changes of the synaptic ultrastructures were observed. The expressions of inducible nitric oxide synthase and neuronal nitric oxide synthase were detected by Western blot, and the levels of tumor necrosis factor-alpha (TNF-α) and interleukin-1 beta (IL-1β) were detected by quantitative real-time PCR.ResultsRats in the CCI group developed hyperalgesia when compared with the sham group. Mechanical withdrawal threshold decreased and thermal withdrawal latency shortened in CCI group. Also, astrocytes at the dorsal horn were activated, the synaptic structure was disordered, the expressions of inducible nitric oxide synthase and neuronal nitric oxide synthase were increased significantly, and the release of inflammatory factor (TNF-α and IL-1β) was up-regulated. However, with early initiation of HBO treatment, rats in the HBO group showed significantly alleviated hyperalgesia, increased mechanical withdrawal threshold, and prolonged thermal withdrawal latency. HBO treatment inhibited astrocyte expression and maintained normal synaptic structure. The expressions of inducible nitric oxide synthase and neuronal nitric oxide synthase were decreased in the dorsal horn, and the release of inflammatory factor (TNF-α and IL-1β) was reduced.ConclusionsEarly HBO treatment significantly improves hyperalgesia in rats with neuropathic pain. The decreased expressions of inducible nitric oxide synthase and neuronal nitric oxide synthase and reduced levels of inflammatory factors are important mechanisms by which early HBO helps to alleviate neuropathic pain.

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“…A systemic review of the existing prospective literature of HBOT for AVNF by Li et al. [20] yielded 9 studies with a collective comparison of 318 HBOT cases to 305 controls; the clinical effect of HBOT for AVNF is 4.95 times higher than perceived in the control group (odds ratio = 4.95, confidence interval [3.24-7.55], P < .00001). A retrospective chart review further confirms HBOT as an effective treatment for AVNF.…”

Section: Discussionmentioning

confidence: 99%

“…HBOT provides another conservative alternative to patients who are poor surgical candidates. However, at present surgery is the most common intervention for ONK [20] . To date, 3 primary types of ONK have been described: Primary or spontaneous osteonecrosis (SONK) typically involves a single condyle, most often the medial femoral condyle.…”

Section: Discussionmentioning

confidence: 99%

Femoral condylar necrosis: treatment with hyperbaric oxygen therapy

et al. 2018

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BackgroundOsteonecrosis of the knee (ONK) is a form of aseptic necrosis resulting from ischemia to subchondral bone tissue. Typically, treatment is invasive. Hyperbaric oxygen therapy (HBOT) may provide a noninvasive alternative by improving oxygenation and reperfusion of ischemic areas. This study evaluates the efficacy of HBOT in a series of ONK patients.MethodsThis retrospective study evaluates 37 ONK patients (29 male, 8 female; mean age ± 1 standard deviation: 54 ± 14); 83.7% of patients presented with Aglietti stage I-II; 16.3% presented with Aglietti stage III. Patients were treated with HBOT once a day, 5 days a week, at 2.5 atmosphere absolute with 100% inspired oxygen by mask for an average of 67.9 ± 15 sessions. Magnetic resonance imaging was performed before HBOT, within 1 year after completion of HBOT, and in 14 patients, 7 years after treatment. Oxford Knee Scores (OKSs) were recorded before HBOT and at the end of each HBOT treatment cycle.ResultsAfter the 30 sessions of HBOT, 86% of patients experienced improvement in their OKS, 11% worsened, and 3% did not change. All patients improved in OKS after 50 sessions. Magnetic resonance imaging evaluation 1 year after HBOT completion showed that edema at the femoral condyle had resolved in all but 1 patient.ConclusionsHBOT is beneficial for treating ONK. Patients experienced improvements in pain and mobility as demonstrated by improvement in OKS. Radiographic improvements were also seen upon post-treatment follow-up. Aglietti staging for the entire sample saw an aggregate decrease (P < .01) from 1.7 ± 0.7 to 0.3 ± 0.6.

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Clinical effect of hyperbaric oxygen therapy in the treatment of femoral head necrosis

Abstract: The results of this study showed that HBO therapy can significantly improve the clinical treatment effect in patients with femoral head necrosis, and that this treatment approach is worthy of clinical application.

Cited by 19 publications

References 37 publications

Short-Term Outcome and MRI Changes in Three Adult Patients with Sickle Cell Disease and Aseptic Osteonecrosis after Treatment with Hyperbaric Oxygen Therapy: A Preliminary Report

Short-Term Outcome and MRI Changes in Three Adult Patients with Sickle Cell Disease and Aseptic Osteonecrosis after Treatment with Hyperbaric Oxygen Therapy: A Preliminary Report

The analgesic effect of early hyperbaric oxygen treatment in chronic constriction injury rats and its influence on nNOS and iNOS expression and inflammatory factor production

Femoral condylar necrosis: treatment with hyperbaric oxygen therapy

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