In a recent study involving 30 patients with avascular necrosis of the hip, researchers observed that after receiving 20 to 30 hyperbaric oxygen therapy (HBOT) treatments, all patients in the study remained pain-free even after 7 years, and none of them required hip reconstruction or replacement.

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Avascular necrosis can occur in various joints such as the hip, knee, shoulder, ankle, elbow, or wrist. However, it is most commonly observed in the hip, particularly affecting the femoral head. The second most common occurrence is in the knee, leading to debilitating pain during walking.

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The causes of avascular necrosis can vary and may include trauma, side effects of certain medications, or underlying diseases. In the case of avascular necrosis of the femoral head, it often results in pain while walking, limping, and sometimes groin pain. Unfortunately, it can significantly impair the mobility of individuals affected by it. However, hyperbaric oxygen therapy has shown promising results in assisting with both hip and knee necrosis.

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Please note that while the information provided reflects the details you provided, it is always important to consult with medical professionals for accurate diagnosis, treatment options, and personalized advice regarding avascular necrosis or any other medical condition.

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Hip Necrosis and Femoral Head Necrosis.

In a 2010 study conducted by Camporesi et al., the effectiveness of hyperbaric oxygen therapy (HBOT) in treating Femoral Head Necrosis (FHN) was examined in a blind cross-over study.

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The study included 30 patients, out of which 19 had stage II FHN according to the Ficat staging system. All patients received a total of 30 HBOT treatments. Initially, there was no significant improvement in range of motion within the first 10 treatments. However, after receiving between 20 to 30 treatments, patients experienced a notable decrease in pain and an increase in stability and range of motion. Remarkably, all 30 patients remained pain-free even after a period of seven years, and none required hip reconstruction or replacement.

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A review of the existing literature on HBOT for treating osteonecrosis, which included a total of ten studies, was also conducted. Gunes et al. reported in 2017 that seven of these studies were well-conducted and demonstrated significant benefits. In each of these studies, HBOT contributed significantly to pain relief and reduction of osteoedema (accumulation of fluid in bone tissue). Long-term effectiveness was found to be more prominent in the earlier stages of avascular necrosis, with magnetic resonance imaging (MRI) often showing a return to normal bone condition. This positive outcome was reflected in increased movement, reduced pain, and prevention of joint collapse. The authors recommended initiating HBOT as early as possible after injury, as it demonstrated long-term efficacy and cost benefits. However, they also emphasized the need for further studies in this area.

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Knee Necrosis (Femoral condylar necrosis)

In 2018, an intriguing study was conducted by researcher Bosco and colleagues, involving a cohort of 37 patients spanning an age range of 29 to 68 years, all afflicted with osteonecrosis of the knee (ONK). The initial course of treatment consisted of administering 30 sessions of hyperbaric oxygen therapy (HBOT). Among the patients, it was observed that 83.7% exhibited knee damage progressing to stage I-II, as denoted by the Aglietti classification, while 16.3% presented with stage III progression.

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Following the completion of the initial 30 HBOT sessions, a noteworthy 86% of the patients experienced marked improvements in their Oxford Knee Scores (OKS), indicating positive advancements in terms of pain alleviation and enhanced mobility. Intriguingly, 11% of the participants witnessed a decline in their OKS, whereas 3% remained unchanged.

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Subsequently, an extended treatment phase consisting of 50 HBOT sessions was initiated, leading to the remarkable outcome of all patients demonstrating amelioration in their Oxford Knee Scores, thus reflecting substantial enhancements in pain management and overall mobility. In order to objectively assess the progress made by the patients, magnetic resonance imaging (MRI) and radiography were employed both before and after the treatment regimen. Notably, post-treatment MRIs displayed a restoration of normal appearance in the femoral condyle (the bone structure within the thigh region), with the absence of edema being observed in all but one individual included in the study.​

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Certain individuals have voiced concerns regarding the perceived inconvenience and cost associated with undergoing 30 to 60 hyperbaric treatments. Nevertheless, it is crucial to consider the minimal side effects and complications associated with HBOT, particularly when juxtaposed with the potential risks and intricacies involved in knee or hip replacement surgeries. It seems rather peculiar to dismiss the option of spending a series of sessions reclining in a chamber, engaging in leisurely activities such as napping or watching a movie, when weighed against the prospect of enduring a life plagued by debilitating pain while walking or the arduous journey of surgery, recovery, and potential complications. Ultimately, the determination of the most suitable course of action should be made by an individual's healthcare provider. However, based on the compelling data presented in this study, HBOT should undeniably be given serious consideration as a viable therapeutic option.

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