Efficacy and safety of platelet-rich plasma combined with core decompression and enhanced bone grafting versus core decompression with enhanced bone grafting alone in treating femoral head necrosis: a systematic review and meta-analysis

被引：0

作者：

Yunqi Cao ^{[1
]}

Xiaolei Deng ^{[2
]}

Siyi Hou ^{[2
]}

Jian Wang ^{[2
]}

Bo Wei ^{[2
]}

Liyou Hu ^{[1
]}

Decai Hou ^{[2
]}

机构：

[1] Liaoning University of Traditional Chinese Medicine, Chongshan Road 79, Shenyang

[2] Affiliated Hospital of Liaoning University of Traditional Chinese Medicine, Beiling Street 33, Shenyang

来源：

Journal of Orthopaedic Surgery and Research | / 20卷 / 1期

关键词：

Core decompression; Femur head necrosis; Meta-analysis; Platelet-rich plasma; Systematic review; Total hip arthroplasty;

D O I：

10.1186/s13018-025-05755-7

中图分类号：

学科分类号：

摘要：

Background: The efficacy and safety of platelet-rich plasma (PRP) combined with core decompression (CD)-enhanced bone grafting for the treatment of osteonecrosis of the femoral head remains controversial. This study aimed to conduct a systematic review and meta-analysis of the efficacy and safety of PRP combined with CD-enhanced bone grafting for treating osteonecrosis of the femoral head and to compare this method with CD-combined bone grafting as a way to provide theoretical bases for future clinical treatments and research. Objective: This study aimed to assess the improved efficacy and safety of core decompression combined with platelet-rich plasma-enhanced bone grafting for osteonecrosis of the femoral head compared to core decompression-enhanced bone grafting. Method: We systematically searched several databases for randomised controlled trials comparing bone graft and core decompression with or without PRP, including 16 studies involving 999 subjects and 1139 hip cases. This meta-analysis followed the Preferred Reporting Items (PRISMA) guidelines. The study is registered with PROSPERO under code CRD42024557968. Result: 16 articles involving 999 patients (1139 hips) were included in this study. Pooled analyses demonstrated that when core decompression-enhanced bone grafting was combined with PRP, the Harris hip score (mean difference [MD]: 5.26, 95% Cl:4.81–5.71; P < 0.00001), visual analog scale (MD: -0.74, 95% Cl:-0.99 – -0.49; P < 0.00001) and reduction in the need for THA: (risk ratio [RR]: 0.29; 95% Cl:0.16–0.53; P < 0.0001) were superior to core decompression-enhanced bone grafting alone. Furthermore, a pooled analysis confirmed the safety of PRP [RR:0.33; 95% Cl:0.13–0.83; P = 0.02]. All these results were statistically significant. Conclusion: Compared to CD-enhanced bone grafting, the combination of PRP appears to yield superior therapeutic outcomes in restoring hip function, alleviating pain, preventing THA, and ensuring postoperative safety. Moreover, we require a higher level of randomised controlled trials to evaluate its efficacy and safety. © The Author(s) 2025.

引用

共 41 条

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