Camporesi
Hyperbaric oxygen therapy improved pain and range of motion for patients with Ficat stage II idiopathic femoral head necrosis
| 1. Pain was significantly reduced following 20 and 30 treatments with HBOT **2. The range of movement was improved following HBOT |
- Citation/s:1. Camporesi E, Vezzani G, Bosco G, Mangar D, Bernasek T. Hyperbaric oxygen therapy in femoral head necrosis. Journal of Arthroplasty 2010;25(6):118-123.
2. Vezzani G, Caberti L, Cantadori L, Mordacci M, Nicolopolou A, Pizzola A, Valesi M. Hyperbaric oxygen therapy (HBO2) for idiopathic avascular femoral head necrosis (IAFHN): a prospective double-blind randomized trial. Undersea and Hyperbaric Medicine 2005; 32(4):272-273.
- Three-part Clinical Question: For patients with Ficat stage II idiopathic femoral head necrosis, does the administration of hyperbaric oxygen result in any improvement in range of motion or pain?
- Search Terms: femoral head necrosis, arthroplasty
- The Study:Double-blinded randomised controlled trial with intention-to-treat.
- The Study Patients: Adult patients with a diagnosis of idiopathic FHN staged at Ficat II after plain X-Ray and MRI confirmation. No specific therapy.
- Control group (N = 10; 9 analysed): Air breathing at 2.5ATA, 30 sessions over six weeks for 80 minutes daily.
- Experimental group (N = 10; 10 analysed): 100% oxygen breathing on the same schedule
- The Evidence:
| Outcome | Air Group | Oxygen Group | Difference | 95% CI | ||
| ^ | Mean | SD | Mean | SD | ^ | ^ |
| Pain (VAS 0 to 10) | 5.3 | 0.6 | 1.4 | 0.3 | 3.9 | 3.69 to 4.11 |
| Non-Event Outcomes | Time to outcome | Air group | Oxygen group | P-value | ||
| ROM in flexion (degrees - median and range) | 30 treatments | 76 (50 - 120) | 112 (92 - 120) | 0.2 | ||
| ROM Extension (degrees - median and range) | 30 treatments | 3.0 (0 - 5.0) | 20 (15 - 20) | < 0.001 | ||
| ROM abduction (degrees - median and range) | 30 treatments | 7.0 (0 -10.0) | 35.5 (26.0 - 45.0) | <0.001 | ||
| Standing load on affected leg (% difference good/affected leg – median and range) | 30 treatments | 18 (10 - 42) | 12 (6 - 22) | 0.06 |
- Comments:
1. The RCT was completed immediately following 30 treatments because all control patients were crossed over to receive HBOT. Not clear how that decsion was reached. 2. Cohort follow-up for seven years suggests gains are maintained and no patient required joint replacement during that time. 3. Clinical significance is unclear, but probable true functional improvement for this group.
- Appraised by: Mike Bennett [| m.bennett@unsw.edu.au] ;Monday 9th October 2017
- Kill or Update By: December 2022
