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Research on Avascular Necrosis of Femoral Headon

  • Hyperbaric Medicine in Israel – The 25 Year Struggle
  • Yehuda Melamed
  • Avascular Necrosis of the head of the femur:
  • Results of treatment of stage I by Hyperbaric Oxygen as compared to an untreated control group.

O. Schwartz1, D. Militianu2, D. Levin3, D. Norman3, Y. Ramon4, A. Shupak5, Y. Melamed4, C. Zinman3, N.D. Reis3.
1Dept. Orthopaedics, Bnai Zion Medical Center, Haifa; 2MRI Unit, Dept. Radiology, Rambam Medical Center; 3Dept. Ortopaedics B’, Rambam Medical Center; 4Rambam-Elisha Hyperbaric Medicine Unit, Haifa; 5Marine Medicine Institute, Zahal, Israel.

Purpose:
To compare the use of hyperbaric oxygen (HBO) and non-weight bearing in the treatment of Stage I avascular necrosis of the femur head (AVNHF) with treatment by non-weight bearing (NWB) only.

Methods:
Vande Berg et al.’s (1) criteria for irreversibility of sub-chondral lesions assessed for thickness and length in AVNFH grade I were used to compare 16 AVN hips treated by HBO with Vande Berg et al.’s group treated by NWB only. 15 hips were "Idiopathic" AVNFH and 1 hip was in a steroid treated Lupus Erythematosus. Only AVNFH grade I was included: cases of bone marrow edema only or transient osteoporosis were strictly excluded as were higher grades of AVNFH.

Results:
Irreversibility likelihood was 88% for thickness of lesion for the control group and 10% for the HBO group. For lesion length irreversibility likelihood was 73% in the controls as compared to 0% in the HBO treated group. Altogether the HBO group registered > 90% total resolution or reduction in size of the sub-chondral lesions (15 hips). The single failure was in the steroid treated Lupus case.

Conclusions: HBO treatment is highly effective in Idiopathic Stage I AVNFH
.

Ref. Vande Berg BC, Malghem JJ, Lecouvet FE, Jamart J, Maldague BE: Idiopathic Bone Marrow Edema Lesions of the Femoral Head: Predictive Value of MR Imaging Findings. Radiology 1999; 212:527-535.

 


For those interested in receiving HBOT that may have difficulty with financing the treatments, we have people that can give advice on fund-raising. The previous case studies are only a glimpse of the hundreds of people which have received HBOT at the Richmond Hyperbaric Center for a variety of conditions with favorable outcomes. Please contact us for more information on a particular condition which may benefit from hyperbaric oxygen therapy.

The Richmond Hyperbaric Health Center has engaged in scientific research projects including a pilot study on the treatment of RSD/CRPS. We would like to pursue future research studies as well and are open to any inquiries about the use of  HBOT  for researching various conditions.

 


 

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