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Surgical management of osteonecrosis of the humeral head: a systematic review.

Forskningsöversiktsartikel
Författare Francesco Franceschi
Edoardo Franceschetti
Michele Paciotti
Guglielmo Torre
Kristian Samuelsson
Rocco Papalia
Jón Karlsson
Vincenzo Denaro
Publicerad i Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA
Volym 25
Nummer/häfte 10
Sidor 3270–3278
ISSN 1433-7347
Publiceringsår 2017
Publicerad vid Institutionen för kliniska vetenskaper, Avdelningen för ortopedi
Sidor 3270–3278
Språk en
Länkar dx.doi.org/10.1007/s00167-016-4169-...
www.ncbi.nlm.nih.gov/entrez/query.f...
Ämneskategorier Ortopedi

Sammanfattning

Osteonecrosis of the humeral head is a rare diagnosis. The aim of this systematic review was to identify published studies and analyse the best clinical evidence available related to the surgical management of osteonecrosis of the humeral head.A systematic electronic search was performed using the PubMed (MEDLINE), EMBASE and Cochrane Library databases. Published studies that reported the outcomes for adult patients treated surgically for osteonecrosis of the humeral head were included. The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement was followed.Twelve studies were included: five prospective case series and seven retrospective case series. A total of 309 patients, comprising 382 shoulders, were included. Three main surgical procedures were evaluated: core decompression, hemi-arthroplasty and total shoulder arthroplasty.Based on the current available data, core decompression is a safe and effective option for treating low-grade osteonecrosis of the humeral head, while hemi-arthroplasty and total shoulder arthroplasty should be considered for high-grade osteonecrosis. More studies and better-designed trials are needed in order to enrich the evidence and enable researchers to draw stronger conclusions. Since osteonecrosis is an uncommon, though challenging disease, a proper knowledge of its treatment is needed.IV.

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