What Researchers Did
Researchers reviewed existing studies on non-surgical treatments for avascular osteonecrosis of the hip in adults.
What They Found
The review found that weight-bearing restriction alone is not enough to stop disease progression. Bisphosphonates might help in early stages, but clear guidelines for dosage and duration are missing. Evidence for hyperbaric oxygen therapy (HBOT), low molecular weight heparin, statins, and vasodilators in treating osteonecrosis was very limited or low, with HBOT also facing concerns about cost and availability. Extracorporeal shock wave therapy may improve pain and function in early stages with low evidence, but does not significantly change the time to femoral head collapse.
What This Means for Canadian Patients
For Canadian patients with early, asymptomatic avascular osteonecrosis of the hip, this review suggests that some conservative treatments might be considered instead of just observation. However, it emphasizes that many non-surgical options, including hyperbaric oxygen therapy, currently have very limited evidence to support their widespread use, prompting careful consideration of treatment choices.
Canadian Relevance
No direct Canadian connection identified.
Study Limitations
This review's conclusions are limited by the generally low and very limited quality of evidence available for many of the conservative treatments discussed.