Paderno E, Zanon V, Vezzani G, Giacon TA, Bernasek TL, Camporesi EM, Bosco G, et al.
International journal of environmental research and public health. Date of publication 2021 Mar 12;volume 18(6):.
1. Int J Environ Res Public Health. 2021 Mar 12;18(6):2888. doi:
10.3390/ijerph18062888.
Evidence-Supported HBO Therapy in Femoral Head Necrosis: A Systematic Review and
Meta-Analysis.
Paderno E(1)(2), Zanon V(1)(2), Vezzani G(1), Giacon TA(1), Bernasek TL(3),
Camporesi EM(4), Bosco G(1).
Author information:
(1)Environmental and Respiratory Physiology Lab and II Level Master in Diving
and Hyperbaric Medicine, Department of Biomedical Sciences, University of
Padova, 35122 Padova, Italy.
(2)DHMU at ICCB, Istituti Ospedalieri Bresciani, GSD-University and Research
Hospitals, 25128 Brescia, Italy.
(3)Adult Reconstruction, Florida Orthopaedic Institute, Tampa, FL 33625, USA.
(4)TEAM Health Research Institute, Tampa, FL 33606, USA.
Although many studies have shown that hyperbaric oxygen (HBO) therapy can
significantly improve symptoms and quality of life of patients affected by
femoral head necrosis, this therapy is not worldwide approved yet. This
meta-analysis was performed to evaluate its clinical effect. Relevant studies
published before May 2020 were systematically searched using terms related to
HBO and femoral head necrosis. Fixed and random-effects models were used to
estimate the odds ratio (OR) with 95% confidence intervals (CI). Subgroup
analyses and publication bias tests were carried out to explore potential study
heterogeneity and bias. Ten studies involving 353 controls and 368 HBO-treated
cases were included, most of which were conducted on Asian population. The
clinical effect in the HBO therapy group was 3.84 times higher than in the
control group (OR = 3.84, 95% CI (2.10, 7.02), p < 0.00001). Subgroup analyses
showed that the clinical effect of HBO therapy was statistically significant in
the Asian subpopulation which represented most of the subjects (OR = 3.53, 95%
CI (1.87, 6.64), p < 0.00001), but not in the non-Asian subpopulation, probably
because of insufficient numerosity (OR = 7.41, 95% CI (0.73, 75.71), p = 0.09).
The results of this meta-analysis suggest that patients with femoral head
necrosis treated with HBO therapy can achieve a significant clinical
improvement.
DOI: 10.3390/ijerph18062888
PMCID: PMC7999152
PMID: 33808951 [Indexed for MEDLINE]
Conflict of interest statement: The authors declare no conflicts of interest
exist with this submission.
