The Journal of Arthroplasty
Volume 25, Issue 6, Supplement , Pages 118-123, September 2010

Hyperbaric Oxygen Therapy in Femoral Head Necrosis

  • Enrico M. Camporesi, MD

      Affiliations

    • University of South Florida, Tampa, Florida
    • Corresponding Author InformationReprint requests: Enrico M Camporesi, MD, University of South Florida, 459 Severn Ave, Tampa, FL 33606.
    • ,
  • Giuliano Vezzani, MD

      Affiliations

    • Ospedale di Vaio (Parma), Italy
    • ,
  • Gerardo Bosco, MD, PhD

      Affiliations

    • Department of Physiology, University G. D'Annunzio, Chieti, Italy
    • ,
  • Devanand Mangar, MD

      Affiliations

    • FGTB Anesthesia Associates, Tampa, Florida
    • ,
  • Thomas L. Bernasek, MD

      Affiliations

    • Corresponding Author InformationReprint requests: Enrico M Camporesi, MD, University of South Florida, 459 Severn Ave, Tampa, FL 33606.
    • Florida Orthopedic Institute, Tampa, Florida

Received 25 January 2010; accepted 17 May 2010. published online 16 July 2010.

Abstract 

We evaluated hyperbaric oxygen (HBO) therapy on a cohort of patients with femoral head necrosis (FHN). This double-blind, randomized, controlled, prospective study included 20 patients with unilateral FHN. All were Ficat stage II, treated with either compressed oxygen (HBO) or compressed air (HBA). Each patient received 30 treatments of HBO or HBA for 6 weeks. Range of motion, stabilometry, and pain were assessed at the beginning of the study and after 10, 20, and 30 treatments by a blinded physician. After the initial 6-week treatment, the blind was broken; and all HBA patients were offered HBO treatment. At this point, the study becomes observational. Pretreatment, 12-month. and 7 year-follow-up magnetic resonance images were obtained. Statistical comparisons were obtained with nonparametric Mann-Whitney U test. Significant pain improvement for HBO was demonstrated after 20 treatments. Range of motion improved significantly during HBO for all parameters between 20 and 30 treatments. All patients remain substantially pain-free 7 years later: none required hip arthroplasty. Substantial radiographic healing of the osteonecrosis was observed in 7 of 9 hips. Hyperbaric oxygen therapy appears to be a viable treatment modality in patients with Ficat II FHN.

Keywords: hyperbaric oxygen therapy, femoral head necrosis, hip arthroplasty

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 No benefits or funds were received in support of the study.

PII: S0883-5403(10)00319-0

doi:10.1016/j.arth.2010.05.005

The Journal of Arthroplasty
Volume 25, Issue 6, Supplement , Pages 118-123, September 2010

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