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Avascular necrosis of the femoral head: Evaluation of hyperbaric oxygen therapy and quality of life.

Introduction
The treatment of avascular necrosis of the femoral head (AVNFH) is based on invasive (e.g., core decompression) and non-invasive methods (e.g., hyperbaric oxygen therapy - HBO2). The purpose of the present study is to evaluate the effect of HBO2 on the quality of life (QoL) of patients with AVNFH.


Methods
This was a prospective observational non-controlled study of patients with AVNFH treated by HBO2. It was conducted, with the use of Steinberg scale, on 73 patients with AVNFH Stage I or II who were treated with HBO2. Patients' QoL was assessed with EuroQol-5D-5L (EQ), Harris Hip Score (mHHS), MAHORN (MHOT), and VAS, in three different phases: before HBO2; after the completion of the first phase (20 HBO2 sessions, up to two months); and after the completion of the second phase (20 HBO2 sessions, up to two months after the first phase). A reassessment was made on the completion of each phase. Ratings were also made after the completion of each phase, over the first five months of follow-up.


Results
All 73 patients (67.1% males, 32.9% females, mean age: 40.34, SD ±± 9.99) participated in the study. Steinberg scale, mean EQ (F (1, 57) = 25.18, η2 = .306 and F (1, 43) = 43.402, η2 = .502); mHHS (F (1, 61) = 67.13, η2 = .524) and F (1, 43) = 31.84, η2 = .425); MHOT (F (1, 61) = 11.68, η2 = .161) and F (1, 43) = 98.01, η2 = .695); and VAS (F (1, 53) = 24.11, η2 = .313) and F (1, 39) = 45.61, η2 = .539), improved between the first and second measurements and between the second and third measurement accordingly (p < .01).


Conclusion
HBO2 treatment does not induce alteration of quality of life and is well tolerated and accepted by patients.