Bayesian Network Meta-Analysis of the Effectiveness of Various Interventions for Nontraumatic Osteonecrosis of the Femoral Head

BioMed Research International
Ji WangXuanwen Bao

Abstract

To assess the effectiveness of various therapeutic hip preservation strategies on patients with nontraumatic osteonecrosis of the femoral head (ONFH). This is a systematic review of previous literature and in-depth Bayesian network meta-analysis of randomized controlled trials (RCTs) to compare the clinical effect of various operation methods and one physical intervention (extracorporeal shockwave). Electronic literature, for studies published up to December 2017, was collected from PubMed, Medline, and the Cochrane Library. We selected RCTs on patients with ONFH. Treatment methods included extracorporeal shockwave (ESW), core decompression (CD), multiple drilling decompression (DD), vascularized fibular grafting (VFG), free-vascularized fibular grafting (FVFG), inverted femoral head grafting (IFHG), vascular iliac pedicle bone grafting (VIPBG), osteotomy, and tantalum implantation (TI). The primary outcome was Harris score; the secondary outcome was Harris hip score (HHS), including total hip arthroplasty requirement (THA) and progression to collapse. A total of 14 randomized controlled trials were investigated. ESW had the highest improvement on Harris score (probability best 52%), followed by VFG (probability was 38%). In th...Continue Reading

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Citations

Sep 24, 2020·Evidence-based Complementary and Alternative Medicine : ECAM·Fanyu FuWeiheng Chen

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Methods Mentioned

BETA
total hip arthroplasties
total hip arthroplasty
scanning electron microscopy
X-ray

Software Mentioned

STATA
GeMTC R package
Cochrane Collaboration
R Development Core Team /
R Foundation for Statistical Computing

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