Review on hyperbaric oxygen treatment in femoral head necrosis

Femoral head necrosis (FHN) is a common invalidating disease with an unclear etiology and pathophysiology that affects middle-aged people. FHN may lead to joint collapse and require invasive treatments. Because of its clinical and socioeconomic significance, an early diagnosis, staging and appropriate treatment are required. Unfortunately, to date a unique algorithm for the treatment of FHN has not been defined.In this report we summarize the Tenth European Consensus Conference on hyperbaric medicine (April 2016, France), during which experts from Europe revised the list of accepted indications for hyperbaric oxygen (HBO₂) treatment, including FHN.In this report all aspects of osteonecrosis discussed during the meeting have been considered: pathophysiology,clinical presentation, standard management, HBO₂ therapy and evidence-based review of its efficacy. All observations are based on a thorough review of the best available research and evidence-based medicine.The Consensus Conference in Lille established FHN as an indication for HBO₂ therapy and suggested a protocols guideline to adopt for this pathology.