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Hyperbaric Oxygen Therapy

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Studies on Avascular Necrosis and HBOT

Avascular Necrosis
HBOT is now approved for the treatment of avascular necrosis.

Avascular Necrosis occurs when bone tissue dies due to a loss of blood supply. This typically occurs at the ends of long bones, such as the hip, knee, shoulder, and ankle.

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Causes include: 

  • Autoimmune disorders (e.g., lupus)

  • Decompression sickness (in divers)

  • Pancreatitis

  • Gaucher disease

  • Trauma (e.g., fractures, dislocations)

  • Certain medications (e.g., corticosteroids, chemotherapy drugs)

  • Radiation therapy

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Hyperbaric Oxygen Therapy helps avascular necrosis by restoring blood supply to affected areas which can delay or eliminate the need for surgery depending on the stage of the condition.

The outcome of hyperbaric oxygen therapy versus core decompression inthe non-traumatic avascular necrosis of the femoral head: Retrospective Cohort Study

​Isam Moghamis a , Abduljabbar A. Alhammoud a , Osama Kokash b , Ghalib Ahmed Alhaneedi c,d,* a Orthopedics Department, Hamad Medical Corporation, PO Box, 3050, Doha, Qatar b HBOT Department, Hamad Medical Corporation, PO Box, 3050, Doha, Qatar c Orthopedic Residency Training Program, Hamad Medical Corporation, Qatar d Weil Cornell Medical College, Qatar

ABSTRACT

Background: Core decompression (CD) has been used in the treatment of pre-collapse stages avascular necrosis (AVN) with good results. Hyperbaric oygen therapy (HBO) was used as a non-invasive treatment for pre-collapse stages osteonecrosis with favorable results. This study aimed to compare the outcomes of HBO versus CD in stage II of non-traumatic AVN of the femoral head.

Methods: Data were collected retrospectively for patients with non-traumatic AVN of the femoral head that was confirmed by MRI and underwent HBO or CD between January 2010 and December 2018, with a minimum follow-up of 12 months. Oxford Hip Score (OHS), radiographic progression, and Short-Form 12(SF12) were used to assess the outcomes. Results: Nineteen patients with 23 stage II AVN of the femoral head were included, 12 (52.2%) in CD, and 11 (47.8%) in the HBO group with an average follow-up of 34.2 ± 18.4 months. 66.7% of patients in CD and 81.8% in the HBO group achieved satisfactory hip function outcome with statis tically significant mean Oxford Hip Score (35.8 ± 6.7 and 35.5 ± 5.1) (P 0.009 & .003) respectively. No statistical difference of OHS and SF12 (PCS &MCS) was found between the two groups (P 0.202, 0.128 & .670 respectively). Eight (34.7%) cases progressed to a higher radiological stage at one year follow-up. The rate of progression was not statistically significant between both groups (P 0.469) with no statistical difference of OHS and SF12 (PCS & MCS) in the progressed group (P 0.747, 0.648 & 0.416) respectively.

Conclusion: This study showed that the HBO is promising and as effective as CD in the treatment of non-traumatic pre-collapsed AVN of the femoral head. Hence, HBO could be used as an alternative non-invasive treatment option.

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