Could BMMNCs therapy reduce the mid- and long-term rate of total hip arthroplasty of femoral head necrosis?: A systematic review and meta-analysis
Bibliographic record
Abstract
BACKGROUND: Osteonecrosis of the femoral head (ONFH) is a cause of hip pain and early joint lesion in patient. The hip-preserving treatments are especially important for patients in early stage of ONFH. However, it is controversial of the effectiveness and safety of bone marrow mononuclear cells (BMMNCs) in the treatment of ONFH. The aim of the study was to explore the mid- and long-term efficacy (particularly the rate of total hip arthroplasty [THA]) with BMMNCs in treatment of ONFH. METHODS: PubMed, Web of Science, Embase, OVID, Cochrane Libriary, CNKI, and Google Scholar databases were searched for relevant randomized controlled trials or non-randomized controlled trials from inception to October 15, 2022. Methodological quality of the trials was assessed, relevant data were extracted, and RevMan 5.3 and Stata 15.0 software were used to perform the meta-analysis of parameters related to the consequences. RESULTS: A total of 22 articles were included, including 1923 patients. Meta-analysis results showed that the treatment of BMMNCs has a significantly lower incidence of THA (odds ratio [OR] = 0.33; 95% confidence interval [CI] = 0.27-0.41, P < .00001), radiographic progression rate (OR = 0.37; 95% CI = 0.21-0.63, P = .0003) and visual analog score at 24 months (mean difference [MD] = -11.84; 95% CI = -14.86 to -8.82, P < .00001), and has higher Harris hip score (MD = 6.90; 95% CI = 4.56-9.24, P < .00001), improvement of visual analog score at 24 months (MD = 6.87; 95% CI = 1.84-11.89, P = .007) and Merle D'Aubigne and Postel hip score (MD = 0.79; 95% CI = 0.14-1.44, P = .02). But there was no significant difference in the Western Ontario and McMaster University Osteoarthritis index (MD = -6.32; 95% CI = -16.76 to 4.12, P = .24) and incidence of complication (OR = 0.86; 95% CI = 0.52-1.42, P = .56). CONCLUSION: Current evidence supports that BMMNCs therapy could reduce the mid- and long-term rate of THA, improve hip function, alleviated the degree of hip pain, delay the progression of imaging staging and not increase the rate of complication, which maybe serve as a preferred option for treating ONFH.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.014 | 0.002 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".