TABLE III.
Treatment | Grade of Recommendation* |
Operative | |
Precollapse | |
Core decompression | A |
Multiple small-diameter drilling | A |
Adjunctive bone-grafting | A |
Cell-based therapy | B |
Nonvascularized bone-grafting | B |
Vascularized bone-grafting | B |
Tantalum rod | C |
Rotational osteotomy | B |
Angular osteotomy | C |
Postcollapse | |
Total hip arthroplasty | A |
Nonoperative | |
Observation | I |
Weight-bearing restriction | I |
Bisphosphonates | I |
Anticoagulants | I |
Vasodilators | I |
Acetylsalicylic acid | I |
Extracorporeal shockwave therapy | I |
Pulsed electromagnetic fields | I |
Hyperbaric oxygen | I |
According to Wright188, grade A indicates good evidence (Level-I studies with consistent findings) for or against recommending intervention; grade B, fair evidence (Level-II or III studies with consistent findings) for or against recommending intervention; grade C, poor-quality evidence (Level-IV or V studies with consistent findings) for or against recommending intervention; and grade I, insufficient or conflicting evidence not allowing a recommendation for or against intervention.