Journal of Hip Preservation Surgery最新文献

{"title":"Short to mid-term outcomes of hip arthroscopy for femoroacetabular impingement and labral tears in patients with diabetes.","authors":"Roger Quesada-Jimenez, Drashti Sikligar, Ady H Kahana-Rojkind, Andrew R Schab, Meredith F Cohen, Benjamin G Domb","doi":"10.1093/jhps/hnaf030","DOIUrl":"10.1093/jhps/hnaf030","url":null,"abstract":"<p><p>The purpose of this study is to report outcomes of patients with Diabetes Mellitus (DM) who underwent hip arthroscopy for femoroacetabular impingement (FAI) at short- to mid-term timepoints comparing these results to a control group of non-DM patients. Data were retrospectively analyzed for patients who underwent primary hip arthroscopy for FAI with a history of DM. Patients had completed pre- and postoperative patient-reported outcomes (PROs) at a minimum 2-year follow-up, including clinically important thresholds for hip arthroscopy, revision surgery, and conversion to arthroplasty. Subanalysis was conducted based on glycemic control. Patients were propensity matched to a control group of nondiabetic patients in a 1:3 ratio. A total of 116 patients were included, with 29 DM patients matched to 87 control patients. DM patients displayed significant improvements across all PROs and high patient satisfaction. No significant differences were observed in the sub-analysis. When compared to a control group, DM patients had lower preoperative PROs and reached similar postoperative scores. DM patients had significantly lower patient satisfaction (7.70 ± 2.43 compared to 8.63 ± 1.57 in the control group <i>P</i> < .05.) at the latest follow-up and had a higher relative risk for revision hip arthroscopy (<i>P</i> < .05). Hip arthroscopy for the treatment of FAI in DM patients resulted in significant short- to mid-term improvements in PROs, comparable to a matched control group. DM patients had an overall 2.63-fold increased relative risk of revision hip arthroscopy compared to non-DM patients, with a trend toward more uncontrolled DM patients undergoing revision hip arthroscopy. Perioperative diabetic control is recommended.</p>","PeriodicalId":48583,"journal":{"name":"Journal of Hip Preservation Surgery","volume":"13 2","pages":"151-159"},"PeriodicalIF":1.6,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13195197/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148018269","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"High rate of graft integration after acetabular labral reconstruction with the knotless pull-through technique.","authors":"Paulo A Perez-Padilla, Omkar N Prabhavalkar, Julio Nerys-Figueroa, Andrew D Carbone, David R Maldonado, Benjamin G Domb","doi":"10.1093/jhps/hnaf036","DOIUrl":"10.1093/jhps/hnaf036","url":null,"abstract":"<p><p>Acetabular labral reconstruction has proven to be a good option for treatment of irreparable labral tears. The purpose of this manuscript is to demonstrate the graft integration in patients who undergo acetabular labral reconstruction with use of allograft. Data were prospectively collected on patients undergoing hip arthroscopy between September 2008 and June 2023 and retrospectively reviewed. The inclusion criteria were patients who underwent hip arthroscopy with labral reconstruction and subsequently underwent a second look arthroscopy for revision surgery. The quality of the integration of the graft used in the previous labral reconstruction was examined by analysing pictures taken during the revision arthroscopy procedure. Three different characteristics of the labral graft were assessed: graft integrity, chondrolabral junction restoration, and anastomosis. There were 12 hips (11 patients) who had labral reconstruction performed in the index surgery with either labral debridement or no labral treatment performed in the revision surgery. There were six females and five males with a mean age of 35.3 years. The mean body mass index was 25.7. The average time between surgeries was 29.5 months. Ten out of 12 hips (83%) were found to have good quality of the graft integrity, with 11 out of 12 labral reconstructions (92%) achieving chondrolabral junction restoration and good anastomosis. Acetabular labral reconstruction demonstrated graft integration at a very high rate. Based on these results, labral reconstruction seems to be a biologically reliable option for irreparable labra with the ability to restore the labral anatomy.</p>","PeriodicalId":48583,"journal":{"name":"Journal of Hip Preservation Surgery","volume":"13 2","pages":"144-150"},"PeriodicalIF":1.6,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13195200/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148018278","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating joint space width and hip morphology in symptomatic female hips with femoroacetabular impingement and instability.","authors":"Brianna N Rowe, Lauren M Heylmun, Antoinette M Pino, Carson L Keeter, Michael B Ellman, James W Genuario","doi":"10.1093/jhps/hnaf051","DOIUrl":"10.1093/jhps/hnaf051","url":null,"abstract":"<p><strong>Purpose: </strong>This study aims to determine differences in joint space width (JSW) between hips with femoroacetabular syndrome (FAIS) and instability, and to investigate the influence of several hip morphological measures on JSW.</p><p><strong>Methods: </strong>A retrospective review of symptomatic female hips, which used standing anterior-posterior x-rays to measure JSW at the medial, superior, and lateral acetabular sourcil, was conducted. Hips were grouped by radiographic indices, collected from 3D-reconstructed models, into cam-femoroacetabular impingement (FAI), pincer-FAI, mixed-FAI, mild instability, instability, and combined FAIS-instability. Associations between JSW and hip morphology measures, including lateral centre edge angle (LCEA), acetabular coverage, Tönnis angle, and femoral neck shaft angle (FNSA), were analysed.</p><p><strong>Results: </strong>In 493 symptomatic female hips, JSW at all locations was significantly lower in pincer hips compared to all other pathology groups (<i>P</i> < .05), with the exception of mixed-FAI hips (<i>P</i> > .4). Hips with isolated instability and combined instability-FAI morphology had significantly greater JSW than pincer- and mixed-FAI groups (<i>P</i> < .05). There were no significant JSW differences between instability and combined FAI-instability groups at any location (<i>P</i> > .1). Acetabular coverage, LCEA, Tönnis angle, and FNSA were significantly associated with JSW (<i>P</i> < .001). No significant associations were observed for acetabular version (<i>P</i> > .05) or femoral torsion (<i>P</i> > .05).</p><p><strong>Conclusion: </strong>Differences in JSW across groups highlight the influence of femoroacetabular morphology and orientation in pre-arthritic hips. In patients with naturally decreased JSW and no other findings of osteoarthritis, attention should be given to evaluation for pincer-FAI. In contrast, in patients with naturally increased JSW, instability findings should be thoroughly evaluated.</p>","PeriodicalId":48583,"journal":{"name":"Journal of Hip Preservation Surgery","volume":"13 2","pages":"135-143"},"PeriodicalIF":1.6,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13195199/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148018312","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Radiographic measures of hip dysplasia correlate only moderately with computationally derived contact mechanics.","authors":"Holly D Aitken, Jessica E Goetz, Aspen Miller, Dominic J L Rivas, Elle McCormick, Robert W Westermann, Todd O McKinley, Michael C Willey","doi":"10.1093/jhps/hnaf047","DOIUrl":"10.1093/jhps/hnaf047","url":null,"abstract":"<p><p>Hip dysplasia is currently diagnosed with two-dimensional radiographic measurements that may not adequately describe the aetiology of pain and dysfunction associated with dysplastic deformity and future osteoarthritis progression. This study aimed to assess how accurately two-dimensional radiographic measurements represent the three-dimensional mechanical joint environment. Spearman <i>ρ</i> correlation was used to determine associations between radiographic measurements of hip dysplasia made on pre-operative and 6-month post-operative standing AP pelvis radiographs, and hip contact stress calculated based on pre- and post-operative pelvis CT scans for a series of 100 patients (125 dysplastic hips) treated with periacetabular osteotomy using discrete element analysis. Only moderate correlations were observed between radiographic measurements and contact mechanics. Pre-operative lateral centre edge angle of Wiberg had the highest, though moderate, correlation with mean cumulative contact stress-time exposure (<i>ρ</i> = -0.5112, <i>P</i> < .0001). Tönnis angle (<i>ρ</i> = 0.4898, <i>P</i> < .0001) and extrusion index (<i>ρ</i> = 0.4579, <i>P</i> < .0001) also had moderate correlations with pre-operative mean cumulative contact stress-time exposure. Only weak correlations were found post-operatively and when comparing change in radiographic measurements to computational contact mechanics metrics before and after surgery. These findings indicate the mechanical environment of the hip joint is more complex than simple radiographic measurements that quantify coverage of the femoral head by the acetabulum. Evaluation of three-dimensional contact mechanics in dysplastic hips should be used in combination with two-dimensional radiographic evaluation for guiding clinical care for patients with hip dysplasia.</p>","PeriodicalId":48583,"journal":{"name":"Journal of Hip Preservation Surgery","volume":"13 2","pages":"123-134"},"PeriodicalIF":1.6,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13195195/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148018335","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Supraacetabular fossa is more prevalent in acetabular protrusion than in dysplastic hips.","authors":"Julien Hirt, Vera M Stetzelberger, Alexander F Heimann, Vlad Popa, Joseph M Schwab, Moritz Tannast","doi":"10.1093/jhps/hnaf054","DOIUrl":"10.1093/jhps/hnaf054","url":null,"abstract":"<p><p>The supraacetabular fossa (SAF) is a bony fossa in the acetabular roof's load-bearing region. Its role in acetabular development and hip morphology remains unclear, with potential implications for hip preservation procedures. We aimed to (i) determine the prevalence of SAF by age, (ii) measure its dimensions in patients with hip pain undergoing magnetic resonance (MR) arthrogram, and (iii) assess associations between SAF and acetabular or femoral morphologies. We performed a retrospective analysis of patients with hip pain who underwent MR arthrograms. SAF were classified as type 1 (unfilled) or type 2 (cartilage-filled), and its dimensions measured. Acetabular and femoral morphology were assessed on radiographs, and hips were categorized into 13 morphology groups. 697 hips from 615 patients were included. SAF was present in 10.9% (76/697) of hips, with affected patients being younger (24.3 ± 7.6 years) than those without SAF (31.8 ± 11.2 years, <i>P</i> < 0.001). Type 1 SAF had a mean depth of 3.1 mm <i>versus</i> 4.8 mm for type 2 (<i>P</i> < 0.001). SAF prevalence was 30.8% in acetabular protrusion and 5.2% in dysplasia (<i>P</i> = 0.0135). Acetabular protrusion (OR 3.78, <i>P</i> = 0.03) were risk factors for SAF, but no associations were found with femoral morphology. SAF occurs predominantly in patients under 25 years and is nearly six times more common in acetabular protrusion than dysplasia. Future studies should investigate the implications of SAF on acetabular rim trimming and reorientation procedures, particularly focusing on their effect on residual joint contact forces.</p>","PeriodicalId":48583,"journal":{"name":"Journal of Hip Preservation Surgery","volume":"13 2","pages":"115-122"},"PeriodicalIF":1.6,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13195188/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148018238","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Short term-outcomes of periacetabular osteotomy in the neuromuscular hip.","authors":"Tobias Stedman, Scott Ryan Booth, Nick Green, Caroline Blakey, Sanjeev Madan","doi":"10.1093/jhps/hnaf050","DOIUrl":"10.1093/jhps/hnaf050","url":null,"abstract":"<p><p>The study aims to evaluate our experience of the Bernese periacetabular osteotomy (PAO) in patients with neurogenic hip dysplasia. Retrospective data were collected for patients with neurogenic hip dysplasia, managed with PAO over a 10-year period. Data were collected for 20 consecutive patients (23 hips). Mean age at the time of surgery was 15 years (range 12-31). 85% had a diagnosis of cerebral palsy (GMFCS 1(18%), 2(18%), 3(35%), 4(12%), 5(18%)). Mean follow up was 47 months. Electronic records were reviewed for outcomes. Pre- and post-operative radiographs were evaluated separately by two independent assessors using TraumaCad software. Post-operative radiographic evaluation was available for 20 patients (21 hips). The median lateral centre edge angle was corrected from -1° pre-operatively (range: -58° to 25°) to 42° post operatively (range: 15° to 65°). Tönnis angle was corrected from an average of 26° pre-operatively (range: 10° to 37°) to 9° post-operatively (range: -19 to 29). Reimer's index decreased from an average of 50% (range: 27% to 93%) to 7% (range 0% to 25%) post-operatively. At the latest follow there was absence of pain in 16 patients. Our experience has demonstrated safe use of the PAO, in conjunction with soft tissue procedures and femoral osteotomy, in the management of neuromuscular patients. In this cohort there was stable reduction of the hip in all but two patients (three hips), and effective pain management for this challenging patient group.</p>","PeriodicalId":48583,"journal":{"name":"Journal of Hip Preservation Surgery","volume":"13 2","pages":"106-114"},"PeriodicalIF":1.6,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13195300/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148018219","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A three-dimensional analysis of fovea morphology in normal and diseased hips.","authors":"Vera M Stetzelberger, Jannine T Segessenmann, Cem Cek, Vlad Popa, Corinne A Zurmühle, Joseph M Schwab, Moritz Tannast","doi":"10.1093/jhps/hnaf046","DOIUrl":"10.1093/jhps/hnaf046","url":null,"abstract":"<p><p>The fovea capitis anchors the ligamentum teres on the femoral head. In normal hips, it resides within the acetabular fossa. However, clinical observations suggest that its position and morphology vary in pathological hips, potentially contributing to joint degeneration through fossa-foveolar mismatch (FFM). Understanding the fovea's morphology is essential to clarifying its role in hip pathomechanics. We asked: (i) what is the proportion of the femoral head occupied by the fovea; (ii) what is the position of the fovea relative to the acetabular fossa; and (iii) what is the FFM index in a defined neutral position for different pathological and normal hips. Using three-dimensional models from computed tomography scans, we analysed 183 hips with femoroacetabular impingement or dysplasia and 22 with normal morphology. Using a standardized medial view of the fovea through the fossa, we determined: (i) the proportion of the fovea surface area on the femoral head; (ii) the positioning of the fovea relative to the fossa; and (iii) FFM indices in all study groups. (i) In normal hips, the fovea accounted for a median of 7% of the femoral head surface. (ii) While the fovea was positioned centrally in normal hips, dysplastic hips demonstrated an anterosuperior displacement of the fovea. (iii) Dysplastic hips had the highest FFM indices (median 0.13; <i>P</i> < .001). This study highlights variations in foveal morphology across different hip pathomorphologies. Foveal size was generally consistent. Foveal position differed markedly, with dysplastic hips showing anterosuperior displacement and the highest FFM indices. These results suggest that altered foveal morphology may contribute to pathological contact and degenerative lesions.</p>","PeriodicalId":48583,"journal":{"name":"Journal of Hip Preservation Surgery","volume":"13 2","pages":"96-105"},"PeriodicalIF":1.6,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13195191/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148018283","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The fulfilment of patients' preoperative expectations and personal goals following periacetabular osteotomy.","authors":"Zachary A Trotzky, Alison J Dittmer, Olivia M Jochl, Brian T Muffly, Carol A Mancuso, Ernest L Sink","doi":"10.1093/jhps/hnaf043","DOIUrl":"10.1093/jhps/hnaf043","url":null,"abstract":"<p><p>Patients electively undergo the treatment of symptomatic acetabular dysplasia by periacetabular osteotomy (PAO). Increasing evidence suggests that a patient's perception of success following orthopaedic surgery is influenced by their preoperative expectations. In response, the Hip Preservation Surgery Expectations Survey (HPSES) was developed to quantify improvement expected and received in domains of pain, function, and psychological well-being. This instrument has not yet been evaluated in a hip preservation sample postoperatively, consistent with a paucity in the literature regarding patient-derived goals. Therefore, the purpose of this study was to describe the fulfilment of expectations following PAO through the HPSES and collection of preoperative personal goals. Preoperatively and at 1-year, 80 participants undergoing PAO (mean age 27.5 ± 9.2 years, 98.8% female) completed the HPSES and/or personal goals surveys. A proportion was calculated as the amount of improvement received versus the amount of improvement expected. The average expectations proportional score was 0.97 with 51.6% achieving a proportional score ≥ 1.0. The average goals proportional score was 0.91 with 50.0% achieving a proportional score ≥ 1.0. Expectations and goals related to day-to-day function, social activity, routine exercise, and relieving stress and anxiety were met most often and correlated to improvement and satisfaction scores. Goals related to high-level physical activity and pregnancy were met less often. Higher preoperative expectations and less attainable goals were associated with lower fulfilment. The appraisal and management of appropriate and realistic goals hold considerable value in achieving patient-perceived satisfaction. PAO is successful in fulfilling expectations related to routine function, social activity, and psychological well-being.</p>","PeriodicalId":48583,"journal":{"name":"Journal of Hip Preservation Surgery","volume":"13 2","pages":"88-95"},"PeriodicalIF":1.6,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13195189/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148018279","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patients undergoing minimally invasive periacetabular osteotomy demonstrate improved outcomes: a systematic review.","authors":"James S MacLeod, Michael S Lee, James D Fox, Kevin Girardi, Serkan Surucu, Stephen M Gillinov, Nancy Park, Ronak J Mahatme, Scott Fong, Jay Moran, Soheil Sabzevari, Andrew E Jimenez","doi":"10.1093/jhps/hnaf048","DOIUrl":"10.1093/jhps/hnaf048","url":null,"abstract":"<p><p>Periacetabular osteotomy (PAO) has demonstrated favourable outcomes for the treatment of acetabular dysplasia. Minimally invasive (MI) PAO uses a smaller incision to preserve soft tissue, minimize complications, and accelerate recovery; however, the outcomes of MI PAO are still being established. The purpose of this study was to conduct a systematic review to assess the reoperation rates and patient-reported outcomes following MI PAO. A systematic review of the literature was conducted in PubMed, CENTRAL, and Scopus in April 2024 with the following keywords: (mini*) AND (periacetabular osteotomy\"). The PRISMA criteria were used. Only studies that reported on patient-reported outcome measures (PROMs) of MI PAO techniques were included. Eight studies with study periods ranging between 2004 and 2021 including a total of 2247 hips were included in this review. Mean follow-up ranged from 12 to 60 months. The mean age at the time of surgery ranged from 20.0 to 38.7 years, and 85.6% of included hips were from female patients. Seven out of 8 included studies reported significant improvement in preoperative vs postoperative PROMs. The mean Non-Arthritic Hip Score ranged from 49.8 to 58.7 preoperatively compared to 77.2-89.4 postoperatively. Mean UCLA scores ranged from 3.9 to 4.67 preoperatively to 6.3-6.97 postoperatively. Mean Harris Hip Scores ranged from 50.8 to 66 preoperatively compared to 87.4-93 postoperatively. Conversion to THA rates ranged from 0% to 5.3% at a mean of 4.9 years (0.6-14). Patients undergoing MI PAO surgery for the treatment of acetabular dysplasia demonstrated low rates of conversion to THA and significant improvement in PROMs at short- to mid-term follow-up.</p>","PeriodicalId":48583,"journal":{"name":"Journal of Hip Preservation Surgery","volume":"13 2","pages":"182-190"},"PeriodicalIF":1.6,"publicationDate":"2025-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13195194/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148018376","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evidence for using synthetic bone grafts for the treatment of osteonecrosis of the femoral head: a systematic review of the literature and meta-analysis.","authors":"Michał Dębiński, Stuart B Goodman, Jerzy Walecki, Konstancja Bobecka-Wesołowska, Marcin K Waśko","doi":"10.1093/jhps/hnaf035","DOIUrl":"10.1093/jhps/hnaf035","url":null,"abstract":"<p><p>Synthetic bone grafts (SBGs) potentially add structural stability after core decompression (CD) for osteonecrosis of the femoral head (ONFH). This systematic review assessed the evidence supporting the (i) radiographic efficacy, (ii) revision rates, and (iii) safety of CD and CD with SBG for the treatment of ONFH. A total of 6549 papers were screened. Inclusion criteria were met by 12 studies for CD and by 14 studies for CD + SBG. This study included 931 hips with Stages I or II of ONFH-414 treated with CD, 379 treated with CD + SBG, and 138 treated with CD + SBG with adjuvant therapies (CD + SBG + ADJ). The radiographic progression was 37% for CD, 33% for CD + SBG, and 32% for CD + SBG + ADJ, with no differences between subgroups (<i>P</i> = .922). The mean total hip arthroplasty conversion rate was 31% for CD, 17% for CD + SBG, and 15% for CD + SBG + ADJ, with no differences between subgroups (<i>P</i> = .08). The complication rates were 0.9% for CD and 2.8% for CD + SBG and CD + SBG + ADJ groups combined. There is no clear evidence that SBGs improve outcomes over CD alone.</p>","PeriodicalId":48583,"journal":{"name":"Journal of Hip Preservation Surgery","volume":"13 2","pages":"74-87"},"PeriodicalIF":1.6,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13195213/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148018303","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}