Application of hyperbaric oxygen therapy in femoral head necrosis: a systematic review and meta-analysis

Purpose: To evaluate the effectiveness of hyperbaric oxygen therapy (HBOT) in the treatment of osteonecrosis of the femoral head (ONFH). Methods: Search for term systems related to ONFH and HBOT in PubMed, Cochrane Library, Embase and Web of Science databases. The risk ratio (RR) was used as the eff...

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Main Authors: Yangbin Cao, Peiyuan Tang, Han Tan, Wenbo Ma, Hua Chai, Bin Lin, Ying Zhu, Wenfeng Xiao, Ting Wen, Jun Zhang, Yusheng Li, Shuguang Liu
Format: Article
Language:English
Published: Bioscientifica 2025-07-01
Series:EFORT Open Reviews
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Online Access:https://eor.bioscientifica.com/view/journals/eor/10/7/EOR-2024-0167.xml
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author Yangbin Cao
Peiyuan Tang
Han Tan
Wenbo Ma
Hua Chai
Bin Lin
Ying Zhu
Wenfeng Xiao
Ting Wen
Jun Zhang
Yusheng Li
Shuguang Liu
author_facet Yangbin Cao
Peiyuan Tang
Han Tan
Wenbo Ma
Hua Chai
Bin Lin
Ying Zhu
Wenfeng Xiao
Ting Wen
Jun Zhang
Yusheng Li
Shuguang Liu
author_sort Yangbin Cao
collection DOAJ
description Purpose: To evaluate the effectiveness of hyperbaric oxygen therapy (HBOT) in the treatment of osteonecrosis of the femoral head (ONFH). Methods: Search for term systems related to ONFH and HBOT in PubMed, Cochrane Library, Embase and Web of Science databases. The risk ratio (RR) was used as the effective index for dichotomous variables while mean difference (MD) and 95% confidence interval (CI) were used as the effective index for continuous variables, with a two-sided P < 0.05 considered statistically significant. I2 statistic and Q test were used to evaluate the statistical heterogeneity of the included studies. Results: Ten studies were included, involving 568 participants. Pre-post meta-analyses to show the visual analog scale after HBOT (MD = −2.94, 95% CI: −4.27, −1.60, P < 0.0001), short form 12 physical component summary scale (SF12 PCS) (MD = 17.28, 95% CI: 8.26, 26.31, P = 0.0002), short form 12 mental component summary scale (SF12 MCS) (MD = 4.26, 95% CI: 2.56, 5.95, P < 0.00001), Harris hip score (HHS) (MD = 26.91, 95% CI: 0.35, 53.46, P = 0.05), modified Harris hip score (mHHS) (MD = 44.31, 95% CI: 13.75, 74.87, P = 0.004) were significantly different from those before treatment. The results of SF12 PCS (MD = −0.39, 95% CI: −7.85, 7.06, P = 0.92) and SF12 MCS (MD = 0.76, 95% CI: −7.02, 8.52, P = 0.85), patients’ improved events (RR = 1.83, 95% CI: 0.37, 9.09, P = 0.46) showed no significant difference between the HBO and non-HBO groups. Conclusion: The results of this study indicate that HBOT cannot be regarded as an effective measure for the treatment of early-stage necrosis of the femoral head and more large-scale randomized controlled trials are needed for further verification.
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spelling doaj-art-7701ac43d31e4bc0b40c0d706381a72b2025-08-20T03:15:36ZengBioscientificaEFORT Open Reviews2058-52412025-07-0110746647410.1530/EOR-2024-01671Application of hyperbaric oxygen therapy in femoral head necrosis: a systematic review and meta-analysisYangbin Cao0Peiyuan Tang1Han Tan2Wenbo Ma3Hua Chai4Bin Lin5Ying Zhu6Wenfeng Xiao7Ting Wen8Jun Zhang9Yusheng Li10Shuguang Liu11Deparment of Orthopedics, Xiangya Hospital, Central South University, Changsha, Hunan, ChinaDeparment of Orthopedics, Xiangya Hospital, Central South University, Changsha, Hunan, ChinaXiangya School of Medicine, Central South University, Changsha, ChinaXiangya School of Medicine, Central South University, Changsha, ChinaXiangya School of Medicine, Central South University, Changsha, ChinaXiangya School of Medicine, Central South University, Changsha, ChinaXiangya School of Medicine, Central South University, Changsha, ChinaDeparment of Orthopedics, Xiangya Hospital, Central South University, Changsha, Hunan, ChinaDeparment of Orthopedics, Xiangya Hospital, Central South University, Changsha, Hunan, ChinaThe First People’s Hospital of Changde City, Changde Hospital, Xiangya Medical College, Central South University, Changsha, ChinaDeparment of Orthopedics, Xiangya Hospital, Central South University, Changsha, Hunan, ChinaDepartment of Joint Surgery, Honghui Hospital, Xi’an Jiaotong University, Xi’an, Shaanxi, ChinaPurpose: To evaluate the effectiveness of hyperbaric oxygen therapy (HBOT) in the treatment of osteonecrosis of the femoral head (ONFH). Methods: Search for term systems related to ONFH and HBOT in PubMed, Cochrane Library, Embase and Web of Science databases. The risk ratio (RR) was used as the effective index for dichotomous variables while mean difference (MD) and 95% confidence interval (CI) were used as the effective index for continuous variables, with a two-sided P < 0.05 considered statistically significant. I2 statistic and Q test were used to evaluate the statistical heterogeneity of the included studies. Results: Ten studies were included, involving 568 participants. Pre-post meta-analyses to show the visual analog scale after HBOT (MD = −2.94, 95% CI: −4.27, −1.60, P < 0.0001), short form 12 physical component summary scale (SF12 PCS) (MD = 17.28, 95% CI: 8.26, 26.31, P = 0.0002), short form 12 mental component summary scale (SF12 MCS) (MD = 4.26, 95% CI: 2.56, 5.95, P < 0.00001), Harris hip score (HHS) (MD = 26.91, 95% CI: 0.35, 53.46, P = 0.05), modified Harris hip score (mHHS) (MD = 44.31, 95% CI: 13.75, 74.87, P = 0.004) were significantly different from those before treatment. The results of SF12 PCS (MD = −0.39, 95% CI: −7.85, 7.06, P = 0.92) and SF12 MCS (MD = 0.76, 95% CI: −7.02, 8.52, P = 0.85), patients’ improved events (RR = 1.83, 95% CI: 0.37, 9.09, P = 0.46) showed no significant difference between the HBO and non-HBO groups. Conclusion: The results of this study indicate that HBOT cannot be regarded as an effective measure for the treatment of early-stage necrosis of the femoral head and more large-scale randomized controlled trials are needed for further verification.https://eor.bioscientifica.com/view/journals/eor/10/7/EOR-2024-0167.xmlfemoral head necrosishyperbaric oxygennecrosisosteonecrosismicrocirculationpain
spellingShingle Yangbin Cao
Peiyuan Tang
Han Tan
Wenbo Ma
Hua Chai
Bin Lin
Ying Zhu
Wenfeng Xiao
Ting Wen
Jun Zhang
Yusheng Li
Shuguang Liu
Application of hyperbaric oxygen therapy in femoral head necrosis: a systematic review and meta-analysis
EFORT Open Reviews
femoral head necrosis
hyperbaric oxygen
necrosis
osteonecrosis
microcirculation
pain
title Application of hyperbaric oxygen therapy in femoral head necrosis: a systematic review and meta-analysis
title_full Application of hyperbaric oxygen therapy in femoral head necrosis: a systematic review and meta-analysis
title_fullStr Application of hyperbaric oxygen therapy in femoral head necrosis: a systematic review and meta-analysis
title_full_unstemmed Application of hyperbaric oxygen therapy in femoral head necrosis: a systematic review and meta-analysis
title_short Application of hyperbaric oxygen therapy in femoral head necrosis: a systematic review and meta-analysis
title_sort application of hyperbaric oxygen therapy in femoral head necrosis a systematic review and meta analysis
topic femoral head necrosis
hyperbaric oxygen
necrosis
osteonecrosis
microcirculation
pain
url https://eor.bioscientifica.com/view/journals/eor/10/7/EOR-2024-0167.xml
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