Hyperbaric Oxygen Therapy as a Therapy Option in the Early Phase of Avascular Necrosis of the Femoral Head

Key Findings of the Study on Hyperbaric Oxygen Therapy (HBOT) in Avascular Necrosis

Background
Avascular necrosis of the femoral head (ANFH) occurs due to disrupted blood supply to the bone, leading to tissue death and joint dysfunction. Early-phase treatment is crucial to prevent progression and joint collapse. Hyperbaric Oxygen Therapy (HBOT) enhances oxygenation in ischemic bone tissues, potentially aiding recovery and delaying disease progression.

Study Design

• Authors: Jure Aljinović, Dinko Pivalica, Ivanka Marinović, Ana Poljičanin, Tonko Vlak, Hrvoje Stipančević, Dušanka Martinović-Kaliterna, Davor Čarić
• Publication: International Journal of Physiatry, 2016
• Focus: The study examines the effectiveness of HBOT as a non-invasive treatment for early-stage ANFH.
• Methodology: The researchers evaluated patients with early-phase ANFH who underwent HBOT, analyzing clinical outcomes and radiological improvements.

Results

1. Clinical Outcomes
   • HBOT significantly reduced pain levels and improved mobility in patients with early-stage ANFH.
   • Most patients reported enhanced quality of life following the therapy.
2. Radiological Improvements
   • Imaging studies revealed reduced edema and improved bone structure in affected femoral heads.
   • Evidence of slowed disease progression was observed in follow-up radiological assessments.
3. Mechanisms of Action
   • Improved Oxygen Delivery: HBOT enhances oxygenation in ischemic bone tissues, supporting angiogenesis and osteogenesis.
   • Anti-Inflammatory Effects: Reduces local inflammation, minimizing further damage to the femoral head.

Implications

• Non-Surgical Alternative: HBOT offers a non-invasive therapy option for early-stage ANFH, potentially delaying the need for surgical intervention.
• Improved Outcomes: Patients benefit from reduced symptoms and slower disease progression, enhancing quality of life.

Caveats

• Limited Sample Size: The study emphasizes the need for larger, randomized trials to confirm findings.
• Accessibility: Availability of HBOT facilities may limit widespread application.
• Stage-Dependent Efficacy: HBOT is most effective in early stages of ANFH, with limited benefits for advanced cases.

Conclusion
This study highlights HBOT as a promising treatment for early-phase avascular necrosis of the femoral head. By reducing symptoms and delaying disease progression, HBOT serves as an effective adjunctive therapy in managing ANFH. Further research is required to establish standardized protocols and confirm long-term benefits.