SynthesisKnee surgery, sports traumatology, arthroscopy : official journal of the ESSKA2025
Orthobiologic therapies delay the need for hip arthroplasty in patients with avascular necrosis of the femoral head: A systematic review and survival analysis.
Synthesis in Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.
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Who cites it
6 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Orthobiologic therapies delay the need for hip arthroplasty in patients with avascular necrosis of the femoral head: A systematic review and survival analysis.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2025Pooled it
- Chinese clinical practice guidelines for minimally invasive hip preservation techniques for femoral head osteonecrosis (2025 edition).International orthopaedics · 2026Review
- Efficacy of PRP versus hyaluronic acid in obese individuals with knee osteoarthritis: a retrospective study.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2026Article
- Surgical treatments of bone marrow lesions.Journal of experimental orthopaedics · 2026Review
- An in-depth examination of bone avascular necrosis and early-stage treatment modalities utilizing regenerative medicine.Iranian journal of basic medical sciences · 2026Review
- Prolotherapy is not superior to control or placebo-based conservative treatments for rotator cuff tendinopathy: a systematic review and meta-analysis.Clinics in shoulder and elbow · 2025Article
Corrections and comments
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeThe aim of this systematic review and survival analysis was to quantify the benefits of orthobiologic augmentation therapies for the treatment of avascular necrosis (AVN) of the femoral head and identify the most effective approach to delay the need for total hip arthroplasty (THA).
methodsA systematic review of the literature was performed on PubMed, Scopus, and Cochrane on clinical studies on orthobiologic therapies used alone or as an augmentation to core decompression or other procedures to address hip AVN. A qualitative analysis of the different biological therapies applied was performed. Afterward, the results of these procedures were quantitatively analysed to document their survivorship from THA compared to treatment groups without orthobiologics. Kaplan-Meier analysis was performed for all studies and then by categorising orthobiologics into treatment subgroups.
resultsA total of 106 studies were included (4505 patients). Different orthobiologic approaches have been evaluated: cell-based therapies including bone marrow aspirate concentrate (BMAC) and bone marrow mesenchymal stromal cells (BM-MSCs), platelet-rich plasma (PRP), or other bioactive molecules applied in the osteonecrotic area or as intra-arterial injections. The survival analysis at 120 months documented a higher (p < 0.0005) cumulative survivorship with orthobiologics (69.4%) compared to controls (48.5%). The superiority was shown specifically for BMAC (p < 0.0005), BM-MSCs (p < 0.0005), intra-arterial (p < 0.0005) and PRP (p = 0.011) approaches, but the direct comparison of these approaches with their controls confirmed benefits only for BMAC (p < 0.0005).
conclusionThis systematic review and survival analysis demonstrated that orthobiologics have the potential to improve survivorship in patients affected by hip AVN. In particular, the specific analysis of different orthobiologic products supported relevant benefits for BMAC augmentation in terms of survival from the need for THA, while no clear benefits were confirmed for other orthobiologics. LEVEL OF EVIDENCE: Level III.
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