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. 2024 Jul 2;12(3):32.
doi: 10.3390/medsci12030032.

Conservative Treatment in Avascular Necrosis of the Femoral Head: A Systematic Review

Evgeniy Nikolaevich Goncharov  1 , Oleg Aleksandrovich Koval  1 , Eduard Nikolaevich Bezuglov  2 , Aleksandr Aleksandrovich Vetoshkin  3 , Nikolay Gavriilovich Goncharov  4 , Manuel De Jesus Encarnación Ramirez  5 , Nicola Montemurro  6
Affiliations

Conservative Treatment in Avascular Necrosis of the Femoral Head: A Systematic Review

Evgeniy Nikolaevich Goncharov et al. Med Sci (Basel). .

Abstract

Introduction: Avascular necrosis (AVN) of the femoral head is a pressing orthopedic issue, leading to bone tissue death due to disrupted blood supply and affecting the quality of life of individuals significantly. This review focuses on conservative treatments, evaluating their efficacy as mainstay therapies. Enhanced understanding of AVN's pathophysiology and advancements in diagnostic tools have rekindled interest in non-surgical interventions, emphasizing personalized, multidisciplinary approaches for improved outcomes.

Material and method: A systematic search was conducted on PubMed, SCOPUS, and Google Scholar databases from January 2020 to August 2023, with the objective of focusing on conservative treatments for AVN of the femoral head. Eligible studies, including original research, case reports, and observational studies, were examined for relevant, well-documented patient outcomes post-conservative treatments, excluding non-English and surgically focused articles without comparative conservative data.

Results: A systematic search yielded 376 records on AVN of the femoral head across multiple databases. After de-duplication and rigorous screening for relevance and quality, 11 full-text articles were ultimately included for a comprehensive qualitative synthesis, focusing on conservatively managing the condition.

Conclusions: This review evaluates the effectiveness of conservative treatments such as pharmacological interventions and physical modalities in managing AVN of the femoral head. Despite promising results in symptom alleviation and disease progression delay, variability in outcomes and methodological limitations in studies necessitate further rigorous, randomized controlled trials for a robust, patient-centric approach to optimize therapeutic outcomes in AVN management.

Keywords: anatomy; avascular necrosis; conservative treatment; femoral head; surgery.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
PRISMA flow diagram of the articles screened.
Figure 2
Figure 2
Avascular necrosis of femoral head pathophysiology. After ischemia, hypoxic vascular endothelial growth factor (VEGF).
See this image and copyright information in PMC

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