Arthroscopic assisted versus open core decompression for osteonecrosis of the femoral head: A systematic review and meta-analysis

作者：Wensi Ouyang, Guimei Guo, Jie Xia, Changwei Zhao, Xiaoling Zhou · 发表于：PLoS ONE · 年份：2024 · DOI：10.1371/journal.pone.0313265 · 被引用次数：8 · 研究领域：Bone and Joint Diseases、Hip disorders and treatments、Orthopaedic implants and arthroplasty

BACKGROUND: Minimally invasive treatment options for osteonecrosis of the femoral head (ONFH) have been a prominent area of research in recent years. Arthroscopic-assisted treatments have been applied in the clinical management of ONFH; however, high-quality evidence verifying their effectiveness and safety is still lacking. OBJECTIVE: To systematically assess the clinical efficacy and safety of arthroscopic-assisted core decompression (AACD) in treating ONFH. METHODS: A comprehensive literature search was conducted in PubMed, Web of Science, EMBASE, Cochrane Library, Chinese National Knowledge Infrastructure, China Science and Technology Journal Database, WanFang, and the Chinese BioMedical Literature Database, from inception to June 25, 2024. We identified randomized controlled trials and non-randomized controlled studies on AACD for the treatment of ONFH based on predefined inclusion and exclusion criteria. A meta-analysis was performed using Review Manager 5.4.1 and Stata 17.0 software. The analyzed outcomes included operative time, intraoperative blood loss, length of hospital stay, postoperative femoral head collapse rate, Harris hip score, and postoperative complication rate. The Grades of Recommendations, Assessment, Development, and Evaluations (GRADE) system was used to assess the quality of evidence for the outcome indicators. RESULTS: A total of fourteen studies were included in this meta-analysis, comprising 1,063 patients-541 in the core decompression (CD) group...