{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T19:26:29Z","timestamp":1787772389718,"version":"build-2784847793"},"reference-count":25,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,11,30]],"date-time":"2022-11-30T00:00:00Z","timestamp":1669766400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100019779","name":"Qatar National Library","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100019779","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:p>Avascular necrosis (AVN) or joint osteonecrosis is a debilitating complication of sickle cell disease, increasing the disease burden on both patients and healthcare systems. AVN can be radiologically categorized into early and late stages depending on the extent of the disease. Management of AVN is challenging and controversial. Generally, it includes conservative measures for early disease to preserve the joint for as long as possible and surgical management for more advanced diseases. Hyperbaric oxygen (HBO) therapy can be used as primary or adjunctive therapy for different medical disorders. Currently, the main rule of HBO in AVN is an adjunctive therapy to control symptoms and improve the quality of life of a patient; however, the concept of using HBO as a primary treatment choice for AVN in patients with sickle cell disease is not well evaluated yet. In this case study, we reported a 15-year-old boy with sickle cell disease who was suffering from stage II AVN in bilateral femoral and right shoulder joints. A total of 57 sessions of HBO resulted in the complete resolution of AVN in post-treatment MRI.<\/jats:p>","DOI":"10.3389\/fmed.2022.1063255","type":"journal-article","created":{"date-parts":[[2022,11,30]],"date-time":"2022-11-30T07:52:39Z","timestamp":1669794759000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":4,"title":["Complete resolution of stage II avascular necrosis affecting three joints by hyperbaric oxygen in a patient with sickle cell disease: A case report"],"prefix":"10.3389","volume":"9","author":[{"given":"Awni","family":"Alshurafa","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammad","family":"Elhissi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamed A.","family":"Yassin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2022,11,30]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"262","DOI":"10.1186\/s12967-021-02931-1","article-title":"Manifestations of HbSE sickle cell disease: a systematic review.","volume":"19","author":"Khamees","year":"2021","journal-title":"J Trans Med."},{"key":"B2","doi-asserted-by":"publisher","first-page":"e2017037","DOI":"10.4084\/MJHID.2017.037","article-title":"Liver iron content (LIC) in adults with sickle cell disease (SCD): correlation with serum ferritin and liver enzymes concentrations in trasfusion dependent (TD-SCD) and non-transfusion dependent (NT-SCD) patients.","volume":"9","author":"Yassin","year":"2017","journal-title":"Mediterr J Hematol Infect Dis."},{"key":"B3","doi-asserted-by":"publisher","first-page":"55","DOI":"10.1080\/16078454.2020.1714113","article-title":"Distribution of sickle cell disease and assessment of risk factors based on transcranial doppler values in the Gulf region.","volume":"25","author":"Wali","year":"2020","journal-title":"Hematol Amst Neth."},{"key":"B4","doi-asserted-by":"publisher","first-page":"962","DOI":"10.4103\/2230-8210.122599","article-title":"Does blood transfusion affect pituitary gonadal axis and sperm parameters in young males with sickle cell disease?","volume":"17","author":"Soliman","year":"2013","journal-title":"Indian J Endocrinol Metab."},{"key":"B5","doi-asserted-by":"publisher","first-page":"33","DOI":"10.23750\/abm.v89i2-S.7085","article-title":"Statural growth and prevalence of endocrinopathies in relation to liver iron content (LIC) in adult patients with beta thalassemia major (BTM) and sickle cell disease (SCD).","volume":"89","author":"Yassin","year":"2018","journal-title":"Acta Bio Med Atenei Parm."},{"key":"B6","doi-asserted-by":"publisher","first-page":"94","DOI":"10.5435\/JAAOS-D-16-00255","article-title":"Orthopaedic manifestations of sickle cell disease.","volume":"26","author":"Vanderhave","year":"2018","journal-title":"J Am Acad Orthop Surg."},{"key":"B7","doi-asserted-by":"publisher","first-page":"607","DOI":"10.1007\/s00256-013-1803-4","article-title":"How do radiologists evaluate osteonecrosis?","volume":"43","author":"Lee","year":"2014","journal-title":"Skeletal Radiol."},{"key":"B8","doi-asserted-by":"publisher","first-page":"1033","DOI":"10.1001\/jama.2014.10517","article-title":"Management of sickle cell disease: summary of the 2014 evidence-based report by expert panel members.","volume":"312","author":"Yawn","year":"2014","journal-title":"JAMA."},{"key":"B9","first-page":"326","article-title":"Low molecular weight heparin prevents the progression of precollapse osteonecrosis of the hip.","volume":"96","author":"Chotanaphuti","year":"2013","journal-title":"J Med Assoc Thail Chotmaihet Thangphaet."},{"key":"B10","doi-asserted-by":"publisher","first-page":"1","DOI":"10.3109\/08880018.2014.960119","article-title":"A practical approach to the use of low molecular weight heparins in VTE treatment and prophylaxis in children and newborns.","volume":"32","author":"Molinari","year":"2015","journal-title":"Pediatr Hematol Oncol."},{"key":"B11","doi-asserted-by":"publisher","first-page":"365","DOI":"10.1159\/000506330","article-title":"Short-term outcome and mri changes in three adult patients with sickle cell disease and aseptic osteonecrosis after treatment with hyperbaric oxygen therapy: a preliminary report.","volume":"13","author":"Shier","year":"2020","journal-title":"Case Rep Oncol."},{"key":"B12","doi-asserted-by":"publisher","first-page":"2519","DOI":"10.1007\/s00264-021-05120-3","article-title":"Hyperbaric oxygen therapy for the treatment of steinberg I and II avascular necrosis of the femoral head: a report of fifteen cases and literature review.","volume":"45","author":"Salameh","year":"2021","journal-title":"Int Orthop."},{"key":"B13","doi-asserted-by":"publisher","first-page":"2888","DOI":"10.3390\/ijerph18062888","article-title":"Evidence-supported HBO therapy in femoral head necrosis: a systematic review and meta-analysis.","volume":"18","author":"Paderno","year":"2021","journal-title":"Int J Environ Res Public Health."},{"key":"B14","doi-asserted-by":"publisher","first-page":"929","DOI":"10.1016\/j.hoc.2005.07.001","article-title":"Bone and joint disease in sickle cell disease.","volume":"19","author":"Aguilar","year":"2005","journal-title":"Hematol Oncol Clin North Am."},{"key":"B15","doi-asserted-by":"publisher","first-page":"1832","DOI":"10.3390\/ijerph18041832","article-title":"Mechanisms of bone impairment in sickle bone disease.","volume":"18","author":"Giordano","year":"2021","journal-title":"Int J Environ Res Public Health."},{"key":"B16","doi-asserted-by":"publisher","first-page":"385","DOI":"10.1093\/qjmed\/hch074","article-title":"Hyperbaric oxygen: its uses, mechanisms of action and outcomes.","volume":"97","author":"Gill","year":"2004","journal-title":"QJM Mon J Assoc Phys."},{"key":"B17","doi-asserted-by":"publisher","first-page":"118","DOI":"10.1016\/j.arth.2010.05.005","article-title":"Hyperbaric oxygen therapy in femoral head necrosis.","volume":"25","author":"Camporesi","year":"2010","journal-title":"J Arthr."},{"key":"B18","doi-asserted-by":"publisher","first-page":"24","DOI":"10.28920\/dhm47.1.24-32","article-title":"Tenth european consensus conference on hyperbaric medicine: recommendations for accepted and non-accepted clinical indications and practice of hyperbaric oxygen treatment.","volume":"47","author":"Mathieu","year":"2017","journal-title":"Diving Hyperb Med."},{"key":"B19","doi-asserted-by":"publisher","first-page":"1501","DOI":"10.1080\/14756366.2018.1485149","article-title":"Hyperbaric oxygen therapy ameliorates osteonecrosis in patients by modulating inflammation and oxidative stress.","volume":"33","author":"Bosco","year":"2018","journal-title":"J Enzyme Inhib Med Chem."},{"key":"B20","doi-asserted-by":"publisher","first-page":"707","DOI":"10.1080\/14756366.2017.1302440","article-title":"Hyperbaric oxygen therapy modulates serum OPG\/RANKL in femoral head necrosis patients.","volume":"32","author":"Vezzani","year":"2017","journal-title":"J Enzyme Inhib Med Chem."},{"key":"B21","doi-asserted-by":"publisher","first-page":"1290","DOI":"10.1359\/jbmr.1998.13.8.1290","article-title":"TNF-alpha increases expression of IL-6 and ICAM-1 genes through activation of NF-kappaB in osteoblast-like ROS17\/2.8 cells.","volume":"13","author":"Kurokouchi","year":"1998","journal-title":"J Bone Miner Res Off J Am Soc Bone Miner Res."},{"key":"B22","first-page":"247","article-title":"Mechanisms of action of hyperbaric oxygen therapy.","volume":"41","author":"Camporesi","year":"2014","journal-title":"Undersea Hyperb Med J Undersea Hyperb Med Soc Inc."},{"key":"B23","doi-asserted-by":"publisher","first-page":"2022","DOI":"10.3389\/fmed.2022.931924","article-title":"Case report: safety and efficacy of voxelotor in a patient with sickle cell disease and stage IV chronic kidney disease.","volume":"9","author":"Alshurafa","year":"2022","journal-title":"Front Med."},{"key":"B24","doi-asserted-by":"publisher","first-page":"931925","DOI":"10.3389\/fmed.2022.931925","article-title":"Real-world data on efficacy of L-glutamine in preventing sickle cell disease-related complications in pediatric and adult patients.","volume":"9","author":"Elenga","year":"2022","journal-title":"Front Med."},{"key":"B25","doi-asserted-by":"publisher","first-page":"4945","DOI":"10.1182\/blood-2021-144636","article-title":"L-glutamine and crizanlizumab for adults with sickle cell disease (SCD) in qatar: a cost effectiveness analysis.","volume":"138","author":"Adel","year":"2021","journal-title":"Blood."}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2022.1063255\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,11,30]],"date-time":"2022-11-30T07:52:43Z","timestamp":1669794763000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2022.1063255\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,11,30]]},"references-count":25,"alternative-id":["10.3389\/fmed.2022.1063255"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2022.1063255","relation":{},"ISSN":["2296-858X"],"issn-type":[{"value":"2296-858X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,11,30]]},"article-number":"1063255"}}