Implantation of core tract autologous bone into decompressed lesion in the core decompression for osteonecrosis of the femoral head

Abstract

Introduction Core decompression (CD) is a treatment modality used to prevent progression of subchondral collapse and arthritic change in osteonecrosis of the femoral head (ONFH). This study aimed to evaluate the outcomes of CD with autologous bone graft to promote rapid bone formation and early postoperative ambulation. Methods This study included 13 patients who received CD for ONFH (≤ 2mm head collapse) with a minimum follow-up of two years. We implanted autologous bone blocks obtained from the decompression tract into the decompressed necrotic area, and the remaining space was filled with 5–10 cc of allograft bone chips or left empty. We then evaluated patients’ clinical and radiographical outcomes. Results The mean visual analog scale improved from 4.7 at admission to 3.1 at the latest follow-up (P = 0.039). The mean modified Harris hip score also improved from 59.8 to 73.2 ( P = 0.027). Mild osteoarthritic changes were noted in most patients (11/13, 84.6%), and the hip survival rate (no further surgeries required) was 76.9%. Three patients underwent total hip arthroplasty due to residual hip pain (mean time to reoperation, 12.7 months). Conclusion Core decompression showed favorable clinical outcomes without any surgery-related complications. This technique may be recommended for the treatment of ONFH.