A Bayesian Network Meta-analysis Of Multiple Conservative Hip Measures For Non-traumatic Femoral Head Necrosis

Objective:To systematically evaluate the short-and medium-term efficacy of multiple Conservative hip measures for the treatment of non-traumatic femoral head necrosis and femoral head survival.Methods:Database search foreign language database: SCI,The Cochrane Library,EMbase,PubMed,Chinese database: CKNI,CBM,VIP,Wanfang,to collect clinical randomized controlled trials(RCTs)related to non-articular replacement therapy for avascular necrosis of the femoral head(ONFH),and appropriate articles were screened.The search period is limited to November 20,2018.The literature was selected and the quality of the literature was evaluated.It was completed by two authors independently.The difference was resolved by the third digit,the data was finally extracted,and the data fitting analysis was performed using Stata and WinBUGS.The main evaluation indicators were the treatment failure rate during the follow-up period.The secondary evaluation index was the HHS comprehensive score and the femoral head survival rate?Results:Finally,20 experiments were analyzed,a total of 1051 hips,863 patients,incl-uding 10 treatments,followed up for 1-5 years.The ending is presented using a cumulative ranking graph.ESWT was the most advantageous in the treatment of efficacy indicators,followed by FVFG.ESWT is still the most advantageous in HHS after treatment,with CD plus Precursor cell implantation followed.Based on the existing treatment methods,with the increase of average life expectancy,the effect of conservatve hip surgery needs further research.In addition,the conclusion of this study still needs to be confirmed by a large number of reasonable and long-term follow-up experiments.Among the indicators of femoral head survival rate,ESWT ranked first,CD plus Precursor cell implantation ranked second.Conclusion:Although ESWT is better than FVFG in terms of efficiency,there is no statistically significant difference between the two.The latter has more evidence to support the best measure.ESWT has obvious advantages in improving HHS,and the combination therapy is significantly better than a single CD or DD.In the comparison of the femoral head survival rate,ESWT is only likely to be the best measure because the statistical difference between the groups is not obvious.