scholarly journals What are the outcomes of core decompression in patients with avascular necrosis? Protocol for a systematic review

F1000Research ◽  
2020 ◽  
Vol 9 ◽  
pp. 71 ◽  
Author(s):  
Octavian Andronic ◽  
Haitham Shoman ◽  
Ori Weiss ◽  
Vikas Khanduja
Keyword(s):  
Systematic Review ◽  
Femoral Head ◽  
Avascular Necrosis ◽  
Meta Analysis ◽  
Core Decompression ◽  
Cochrane Library ◽  
Decompression Surgery ◽  
Surgical Methods ◽  
Staging Systems ◽  
Augmentation Techniques

Background: Core decompression is a hip preserving surgical procedure that is used to treat avascular necrosis (AVN) of the femoral head. The eventual clinical and radiological outcome following this procedure is varied in literature. Also, the time to a total hip replacement (THR) from the index procedure and the percentage of patients subsequently undergoing a THR is controversial. Furthermore, there are multiple surgical methods along with multiple augmentation techniques and various classification and staging systems described. The purpose of this systematic review, therefore, is to analyse the outcomes following decompression only, excluding any augmentation techniques for non-traumatic AVN of the femoral head. Methods: This protocol is being developed in line with the PRISMA-P guidelines. The search strategy includes articles from Medline, Embase, Google Scholar, CINHAL and Cochrane library. The review and screening will be done by two independent reviewers. Review articles, editorials and correspondences will be excluded. Articles including patients with sickle cell disease and with core decompression where augmentation is used will be excluded. The risk of bias and quality of articles will be assessed using the Joanna Briggs Institute Critical Appraisal Checklist for the different study designs included. Discussion: This study will be a comprehensive review on all published articles having patients with AVN of the femoral head and undergoing core decompression surgery only. The systematic review will then define the outcomes of the core decompression surgery based on clinical and radiological outcomes. Each outcome will include the different stages within it and finally, the total mean time to THR will be calculated. This will then be followed by assessing the cumulative confidence in evidence from all the data collected using the GRADE tool.   Registration: This systematic review is registered in the International Prospective Register for Systematic Reviews and Meta-analysis (PROSPERO) under the registration number: CRD42018100596

scholarly journals Correction to: Regenerative therapies increase survivorship of avascular necrosis of the femoral head: a systematic review and meta-analysis

2018 ◽  
Vol 43 (2) ◽  
pp. 505-505 ◽  
Author(s):  
Luca Andriolo ◽  
Giulia Merli ◽  
Carlos Tobar ◽  
Sante Alessandro Altamura ◽  
Elizaveta Kon ◽  
...  
Keyword(s):  
Systematic Review ◽  
Femoral Head ◽  
Avascular Necrosis ◽  
Meta Analysis ◽  
Regenerative Therapies

Surgical or medical abortion of pregnancies between 13+0 and 23+6 weeks’ gestation? A systematic review and new NICE national guidelines

2020 ◽  
pp. bmjsrh-2019-200460
Author(s):  
Mia Schmidt-Hansen ◽  
Patricia A Lohr ◽  
Sharon Cameron ◽  
Elise Hasler
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Cochrane Collaboration ◽  
Medical Abortion ◽  
Cochrane Library ◽  
National Guidelines ◽  
Cervical Injury ◽  
Surgical Methods ◽  
Randomised Controlled

BackgroundAbortion in the second trimester may be performed surgically or medically. The objective of this systematic review was to examine the effectiveness, safety and acceptability/satisfaction of surgical compared with medical abortion of pregnancy between 13+0 and 23+6 weeks’ gestation for a new national guideline.MethodsWe searched Embase, Medline and the Cochrane Library on 4 March 2019. We included randomised controlled trials (RCTs; any size) and non-randomised comparative studies with n≥100 in each arm, published in English from 1985. Risk-of-bias was assessed using the Cochrane Collaboration checklist for RCTs. Meta-analysis of risk ratios (RRs)used the Mantel-Haenszel method. The quality of the evidence was assessed using GRADE.ResultsTwo RCTs (n=140) were included. ‘Incomplete abortion requiring surgical intervention’ was clinically significantly higher with medical than surgical methods (RR=4.58, 95% CI 1.07 to 19.64). ‘Abortion completed by the intended method’ was statistically, but not clinically, significantly lower after medical than surgical methods, but was marked by high between-study heterogeneity (RR=0.88, 95% CI 0.79 to 0.98). To the extent that ‘haemorrhage requiring transfusion/≥500 mL blood loss’, ‘uterine injury’, ‘cervical injury requiring repair’ and ‘infection reported within 1 month of abortion’ were reported, they did not differ significantly between methods. Depending on measurement method, ‘patient satisfaction/acceptability’ was either clinically significantly higher or comparable after surgical than medical methods. The quality of this evidence was limited by low event rates and attrition bias.ConclusionBased on this evidence and consensus, women should be offered the choice of medical or surgical methods of abortion between 13+0 and 23+6 weeks’ gestation, unless not clinically appropriate.

scholarly journals Autologous Stem Cells Combined Core Decompression for Treatment of Avascular Necrosis of the Femoral Head: A Systematic Meta-Analysis

2017 ◽  
Vol 2017 ◽  
pp. 1-11 ◽  
Author(s):  
Shibing Xu ◽  
Lei Zhang ◽  
Hongting Jin ◽  
Letian Shan ◽  
Li Zhou ◽  
...  
Keyword(s):  
Stem Cells ◽  
Bone Marrow ◽  
Femoral Head ◽  
Avascular Necrosis ◽  
Meta Analysis ◽  
Core Decompression ◽  
Autologous Bone Marrow ◽  
Bone Marrow Stem Cells ◽  
Harris Hip Score ◽  
Autologous Bone

Objective. This study aims to systematically evaluate the efficacy and safety of core decompression combined transplantation of autologous bone marrow stem cells (CDBMSCs) for treatment of avascular necrosis of the femoral head (ANFH). Methods. Randomized controlled trials (RCTs) regarding effectiveness of core decompression combined transplantation of autologous bone marrow stem cells for treating ANFH were searched in 8 comprehensive databases prior to September 2016. The data analysis was performed by using the RevMan version 5.3. Results. A total of 11 studies with 507 participants were included. Results showed that CDBMSCs group was more effective than CD group in increasing Harris hip score, decreasing necrotic area of femoral head, collapse of femoral head, and conversion to total hip replacement incidence. In the subgroup analysis, the results did not change in different intervention measure substantially. In addition, the safety of CDBMSCs for ANFH is reliable. Conclusion. Based on the systematic review, our findings suggest that core decompression combined transplantation of autologous bone marrow stem cells appeared to be more efficacious in the treatment at early stages of ANFH.

scholarly journals Regenerative therapies increase survivorship of avascular necrosis of the femoral head: a systematic review and meta-analysis

2018 ◽  
Vol 42 (7) ◽  
pp. 1689-1704 ◽  
Author(s):  
Luca Andriolo ◽  
Giulia Merli ◽  
Carlos Tobar ◽  
Sante Alessandro Altamura ◽  
Elizaveta Kon ◽  
...  
Keyword(s):  
Systematic Review ◽  
Femoral Head ◽  
Avascular Necrosis ◽  
Meta Analysis ◽  
Regenerative Therapies

Vascularized fibular grafts in patients with avascular necrosis of femoral head: a systematic review and meta-analysis

2012 ◽  
Vol 133 (1) ◽  
pp. 1-10 ◽  
Author(s):  
Taolin Fang ◽  
Elizabeth W. Zhang ◽  
Frederick C. Sailes ◽  
Robert A. McGuire ◽  
William C. Lineaweaver ◽  
...  
Keyword(s):  
Systematic Review ◽  
Femoral Head ◽  
Avascular Necrosis ◽  
Meta Analysis ◽  
Necrosis Of Femoral Head
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