Quality of life of patients with avascular femoral head necrosis treated with hyperbaric oxygen

ABSTRACT Introduction: Avascular Femoral Head Necrosis (AFHN) is a disease whose etiology is not completely elucidated and partly unknown but this pathologic entity is the final common pathway of non-traumatic factors that compromise and at last interrupt the particular circulation of the femoral head. The treatment of AFHN is based on invasive (core decompression, bone grafting and osteotomy) and non-invasive methods (electrical stimulation, magnetic fields, medication, and hyperbaric oxygen therapy HBO). Aim: To evaluate the effect of HBO on the Quality of Life (QoL) of patients with AFHN when used in conjunction with internationally accepted non-surgical treatment. Material and Method: A clinical study was performed with one intervention group lasting 3.5 years. It was performed in 73 patients, who were referred from a special orthopedic for HBO with stage I or II AFHN according to the Steinberg scale. Patients evaluated their health related QoL (HR-QoL) by completing EuroQol-5D-5L (EQ) and VAS for pain before HBO, after the 1st phase (20 HBO) and after the 2nd phase (additional 20 HBO). Results: Before HBO, at the 1st and 2nd phases, the mean EQ was 58.01, 65.07 and 77.36 respectively while Pain rating (VAS) was 5.4 (+/- TA: 1.9), 4.8 (+/- TA: 1.8), indicating an improvement in the quality of life of the patients. Conclusions: HBO significantly affects HR-QoL in patients with AFHN. Pain and quality of the patient's usual activities are related to the use of HBO. Larger studies are required for more thorough evaluation