Banca de DEFESA: VINICIUS DE BRITO RODRIGUES

Uma banca de DEFESA de MESTRADO foi cadastrada pelo programa.
STUDENT : VINICIUS DE BRITO RODRIGUES
DATE: 01/07/2022
TIME: 14:00
LOCAL: Sessão Remota
TITLE:

Isolated femoral head decompression versus conservative treatment for non-traumatic osteonecrosis: a systematic review with meta-analysis

KEY WORDS:

osteonecrosis, femoral head, core decompression, total hip arthroplasty, preserving joint treatments

PAGES: 39
BIG AREA: Ciências da Saúde
AREA: Saúde Coletiva
SUMMARY:

Introduction: Osteonecrosis of the femoral head (ONCF) is a condition that can lead to progressive destruction of the hip joint, common between the third and fifth decades of life, being the diagnosis responsible for 5 to 18% of total hip arthroplasties (THA). ). Among joint sparing treatments, the role of central decompression (CD) is still debated. Objective: To compare the effectiveness of central decompression (DC) and conservative treatment (CT) to save femoral heads in patients with avascular necrosis of the femoral head. Results: Four clinical trials and two cohorts involving 316 hips, with a mean follow-up of 22 to 48 months were included in this review. Our results suggested that patients undergoing CD were less likely to undergo total hip replacement surgery [OR = 0.42 (95% CI, 0.20–0.85); I 2 = 0.00%; p = 0.74]. In the analysis of the radiographic progression rate stratified by the stage of ONCF, the CD group had a significantly lower failure rate than the CT group at stages 0/I, [OR = 0.32 (95% CI, 0.11– 0.96); I 2 = 25.41%; p = 0.26], but not in stage II [OR = 0.68 (95% CI, 0.14–3.34); I 2 = 71.84%; p < 0.01] nor in stage III [OR = 1.21 (95% CI, 0.11–12.85; I 2 = 67.37%; p = 0.05)]. Conclusions: Performing CD is effective in preventing progression to femoral collapse in the early stages of ONCF in a short-term follow-up and reduces the chance of total hip arthroplasty. However, the short-term follow-up and small sample size of the current meta-analysis provide only limited quality of evidence. Randomized controlled trials with a larger sample size and longer follow-up are needed to provide further insights into the optimal treatment of ONCF.

BANKING MEMBERS:
Presidente - 1226136 - JOILDA SILVA NERY
Externo ao Programa - 286128 - GILDASIO DE CERQUEIRA DALTRO
Externo ao Programa - 1321461 - VINICIUS DE ARAUJO MENDES
Externa à Instituição - JANE MARY DE MEDEIROS GUIMARÃES