The Use of Iloprost in the Treatment of Bone Marrow Edema Syndrome of the Proximal Femur : A Review and Meta-Analysis

Affiliation
Department of Orthopedic Surgery, University of Ulm, Oberer Eselsberg 45, 89081 Ulm, Germany
Zippelius, Timo;
Affiliation
Orthopedic Department, Jena University Hospital, Campus Eisenberg, 07607 Eisenberg, Germany
Strube, Patrick;
Affiliation
Orthopedic Department, Jena University Hospital, Campus Eisenberg, 07607 Eisenberg, Germany
Rohe, Sebastian;
GND
138812187
Affiliation
Institute of Medical Statistics, Computer Sciences and Documentation, Jena University Hospital, 07743 Jena, Germany
Schlattmann, Peter;
Affiliation
Department of Orthopedic Surgery, University of Ulm, Oberer Eselsberg 45, 89081 Ulm, Germany
Dobrindt, Oliver;
ORCID
0000-0001-9468-2089
Affiliation
Department of Orthopedic Surgery, University of Ulm, Oberer Eselsberg 45, 89081 Ulm, Germany
Caffard, Thomas;
Affiliation
Department of Orthopedic Surgery, University of Ulm, Oberer Eselsberg 45, 89081 Ulm, Germany
Awan Malik, Hassan;
Affiliation
Orthopedic Department, Jena University Hospital, Campus Eisenberg, 07607 Eisenberg, Germany
Lindemann, Chris;
Affiliation
Orthopedic Department, Jena University Hospital, Campus Eisenberg, 07607 Eisenberg, Germany
Matziolis, Georg;
ORCID
0000-0002-6976-8953
Affiliation
Orthopedic Department, Jena University Hospital, Campus Eisenberg, 07607 Eisenberg, Germany
Böhle, Sabrina

Objective: The aim of this meta-analysis was to investigate the impact of intravenous iloprost therapy on pain, function, edema changes, and follow-up surgery in bone marrow edema syndrome of the proximal femur. Methods: A systematic literature search up to May 2022 was performed to find relevant papers that made a statement about the outcome of intravenous iloprost therapy alone. Factors such as the Visual Analog Scale (VAS), Harris Hip Score (HHS), edema reduction, and follow-up interventions were considered. These were compared using Forest plots. Results: In 11 studies, 190 proximal femora with bone marrow edema syndrome that received intravenous iloprost therapy without further therapeutic intravenous or surgical intervention such as core decompression were studied. There was a significant mean improvement in VAS by 3.3 cm (2.07–4.5 cm) ( p < 0.001) and HHS by 24.36 points (18.23–30.49) ( p < 0.001) 3–6 months after receiving iloprost therapy. Only in 9.3% of cases (1.1–24.3%) did no clinical or radiological improvement occur. Conclusions: It could be shown that the existing publications support intravenous therapy with iloprost in patients with bone marrow edema syndrome and result in good clinical outcomes.

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