Table 2.
The clinical outcomes of different hip preservation methods for ANFH.
| Study | Article type | Sample size(No. of hips) | Stage of disease | Age | Implants or procedures | Median follow-up (months) | Hip survival (%) | HHS |
|---|---|---|---|---|---|---|---|---|
| Core decompression | ||||||||
| K. Hua, 2019 | Meta-analysis | 1323 | ARCO Ⅰ-Ⅲ; | 37.72 (12–85) | Traditional core decompression | 54.3 | 66% | / |
| Q. Wang, 2020 | Retrospective study | 59 | ARCO Ⅱ | 39.1 ± 10.2 | Traditional core decompression | 48 | 69.5% | 80.2; 7.3 improved |
| S. Lakshminarayana, 2019 | Observational study | 36 | Fiact Ⅰ-Ⅱ | 30.07 (18–48) | Traditional core decompression | 53.5 | / | 77; 29 improved |
| J. S. Kang, 2018 | Retrospective study | 53 | ARCO Ⅰ-Ⅳ | 47.3 ± 9.7 | Traditional core decompression | 51.36 | 51% | / |
| Core decompression combined with cell-based therapy | ||||||||
| M. Grassi, 2020 | Prospective study | 30 | Ficat Ⅰ-ⅡB | 42 (23–60) | Traditional core decompression; PRP | 60 | 53% | 84; 20 improved |
| K. Hua, 2019 | Meta-analysis | 372 | ARCO Ⅰ-Ⅲ | 37.72 (12–85) | Traditional core decompression; Bone marrow | 54.3 (2–228) | 84% | / |
| J. S. Kang, 2018 | Retrospective study | 53 | ARCO Ⅰ-Ⅳ | 46.0 ± 9.3 | Traditional core decompression; BMMSC | 51.36 | 71.7% | / |
| Y. W. Lim, 2013 | Retrospective study | 128 | Ficat Ⅰ-Ⅲ | 36.3 ± 9.7 | Multiple drilling core decompression; BMMSC | 87 (8–134) | 55.5% | / |
| Bone substitute materials implantation | ||||||||
| S. Landgraeber, 2017 | Prospective study | 31 | ARCO Ⅱ | 42.9 (21–60) | Calcium sulfate (CaSO4)-calcium phosphate (CaPO4) | 30.06 (12–43.3) | 75.9% | 83.78; 10.13 improved |
| B. L. Wang, 2010 | Prospective study | 138 | ARCO ⅡA-ⅢA | 32.36 (17–54) | Demineralized bone matrix (DBM) and auto-iliac bone | 25.37 (7–42) | ⅡA-ⅡB: 85%; ⅡC-ⅢA: 60% | 79; 17 improved |
| J. E. Hsu, 2011 | Prospective study | 62 | Steinberg Ⅰ-Ⅱ | 40.6 (20–65) | Grafton Demineralized Bone Matrix (Osteotech, Eatontown) | 46.3 (24–107) | 62.9% | / |
| S. B. Kizer, 2006 | Retrospective study | 80 | Ficat Ⅰ-Ⅳ | 36 ± 13.2 | Allogeneic cortical strut grafts (tibia/fibular) | 108 (48–204) | 59% | / |
| B. F. Wei, 2011 | Retrospective study | 223 | ARCO Ⅱ-ⅡA | 33.5 (19–54) | Allogeneic fibular | 24 | 81% | / |
| Y. Zeng, 2015 | Retrospective study | 18 | ARCO ⅡB-ⅡC | 40.7 (22–49) | Allogeneic bone | 53.3 (20–107) | 78% | 83.8; 22.2 improved |
| Tantalum rod implantation | ||||||||
| Y. Liu, 2015 | Prospective study | 59 | Steinberg Ⅰ-Ⅳa | 43 (21–70) | Porous tantalum rod | 60 | 72.49% | 78; 19 improved |
| Y. Zhang, 2021 | Retrospective study | 52 | ARCO Ⅰ-Ⅱ | 40.1 ± 9.3 | Porous tantalum rod | 85.7 (60–132) | 52.9%; 6-year: 60% |
69.7; 3.7 reduced |
| Non-vascularized autograft implantation | ||||||||
| K. Hua, 2019 | Meta-analysis | 427 | ARCO Ⅰ-Ⅲ | 37.72 (12–85) | Traditional core decompression; Autologous bone | 54.3 (2–228) | 82% | / |
| S. Lakshminarayana, 2019 | Observational study | 40 | Ficat Ⅰ-Ⅱ | 30.07 (18–48) | Traditional core decompression; non-vascularized fibular graft | 53.5 (44–63) | / | 71.5; 8.5 improved |
| Q. Wang, 2020 | Retrospective study | 66 | ARCO Ⅱ | 38.1 ± 10.0 | Light bulb technique; Autologous bone | 48 | 84.8% | 83.1; 9.4 improved |
| C. Yildiz, 2017 | Retrospective study | 28 | Steinberg Ⅰ-Ⅳ | 34 (22–50) | Light bulb technique; Autologous bone | 52.6 (24–80) | 82.1% | 74.33; 21.67 improved |
| D. Li, 2017 | Retrospective study | 83 | ARCO Ⅱ | 38.2 ± 8.2 | Light bulb technique; Autologous bone | 36 (32–44) | 86.7% | 86.5; 14.1 improved |
| Vascularized bone grafting | ||||||||
| L. Cao, 2017 | Prospective study (RCT) | 21 | ARCO Ⅰ-ⅢB | 31 ± 6 | Free vascularized fibular grafting | 36 | 95.2% | 82 |
| H. Xie, 2019 | Retrospective study | 1006 | Ficat Ⅱ-Ⅳ | 38 (18–55) | Vascularized iliac bone grafting | 60 | 88.7% | 87.43; 21.01 improved |
| D. Zhao, 2017 | Retrospective study | 2190 | Ficat Ⅱ-Ⅳ | 43.15 ± 9.14 | Pedicled iliac bone flap transfer | 144 (60–300) | 90.1% | 83.63; 17.09 improved |
| β-TCP system in this study | ||||||||
| Y. Lu et al. | Prospective study (multi-center) | 246 | ARCO Ⅱ-Ⅲ | 43 (17–65) | β-TCP system | 42.79 ± 12.89 | 82.1% | 80.26; 22.31 improved |
Notes: ARCO, Association Research Circulation Osseous; PRP, platelet-rich plasma; BMMSC, bone marrow mesenchymal stem cell.