TOTBİD Dergisi

TOTBİD Dergisi

2020, Cilt 19, Sayı, 6     (Sayfalar: 869-872)

Hyperbaric oxygen therapy as a treatment for avascular necrosis of the femoral head

Cem Coşkun Avcı 1, Mehmet Kürşat Yılmaz 1, Deniz Gülabi 2

1 İstanbul Medipol Üniversitesi Tıp Fakültesi, Ortopedi ve Travmatoloji Anabilim Dalı, İstanbul
2 İstanbul Kanuni Sultan Süleyman Eğitim ve Araştırma Hastanesi, Ortopedi ve Travmatoloji Kliniği, İstanbul

DOI: 10.14292/totbid.dergisi.2020.108
Görüntüleme: 1174
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İndirme : 1911

Avascular necrosis is the death of trabecular bone and bone marrow and is most common in the femoral head. The pathogenesis is believed to result from ischemia caused by intraosseous microcirculation impairment. The aim of the treatment is to prevent the collapse of the femoral head and thus to stop the development of osteoarthritis. Hyperbaric oxygen therapy acts by aiming to correct the underlying pathophysiology of avascular necrosis of the femoral head. This treatment involves supplying 100% oxygen to the whole body at pressures higher than atmospheric pressure. Hyperbaric oxygen therapy causes vasoconstriction in the arterioles, reducing inflammation and promoting collagen and blood vessel synthesis (angiogenesis). It also provides direct oxygenation of the necrotic region in the trabecular bone via the extracellular fluid. As a result of all these, venous pressure decreases in the femoral head and microcirculation improves. Thus clinically, pain is significantly reduced and joint movements are increased. Hyperbaric oxygen therapy can be applied in patients diagnosed with avascular necrosis in the early period (stage I-II) alone or together with other treatments (cocktail therapy) instead of only observation.

Anahtar Kelimeler : avascular necrosis; osteonecrosis; hyperbaric oxygen therapy; conservative therapy