This is the official website for ARCO, an international society promoting the study of bone circulation and its disorders.
The aims of ARCO are to encourage, coordinate and undertake clinical and basic research in the field of bone circulation and its disorders, in particular of osteonecrosis, to initiate and keep an international dialogue alive among bone circulation experts.
Development of Clinical Practice Guidelines for
Osteonecrosis of the Femoral Head
This initiative, spearheaded by Edward Cheng, M.D., is being conducted to develop evidence-based practice guidelines regarding the diagnosis and treatment of osteonecrosis of the femoral head. The 3 PICO questions that are being addressed include:
In patients undergoing diagnostic evaluation for ONFH, what imaging studies (radiographs, MRI, CT) are most sensitive and specific for:
detecting a subchondral fracture
monitoring the effect of any intervention
correlate with symptomatic vs asymptomatic disease
In patient s with ONFH, ARCO stage 1-2 (without femoral head fracture or collapse):
what treatment (eg., bisphosphonates, core decompression [CD] with autogenous graft, CD + bone graft substitutes, CD + cellular stem cell therapy) is best at preventing a subsequent femoral head subchondral fracture?
for asymptomatic patients, does treatment vs. serial observation reduce the risk of a subchondral femoral head fracture?
for symptomatic patients, should THA be performed to reduce pain?
In patients with ONFH, ARCO stage 3 (with a femoral head fracture, with or without collapse) what surgical treatment (eg., rotational osteotomy, hemiarthroplasty, surface replacement arthroplasty, total hip arthroplasty) yields the best functional outcome over: