Projects

Aims and background: To assess the clinico-radiological and functional outcome of core decompression with bone grafting in avascular necrosis (AVN) of the femoral head, and compare the different types of bone grafts used in the AVN of the femoral head. Performing core decompression early in its progression, before collapse, may halt or reverse its advancement and potentially preserve the femoral head's integrity. Therefore, we conducted an analysis of the clinical, functional, and radiological outcomes following core decompression and bone grafting in patients diagnosed with osteonecrosis of the femoral head (ONFH) up to stage III of Ficat–Arlet staging. 
Materials and methods: A study conducted at our institute from June 2022 to February 2024 involved treating 18 patients (30 hips) with ONFH up to grade III (Ficat and Arlet) using core decompression and corticocancellous and cortical bone grafting. Cancellous grafting from the iliac crest was utilized in 18 out of 30 hips, while cortical nonvascularized fibular grafts were employed in 12 out of 30 patients. 
Results: Functional outcome was assessed by the Harris hip score (HHS), where 12 hips (40%) had a good outcome; 11 hips (36.66%) had a fair outcome. However, five hips (16.66%) showed poor results. For stage II, 16/18 hips (88.8%) improved, whereas for stage III, 9/12 hips (75%) showed improvement. 
Conclusion: Core decompression and bone grafting yielded favorable outcomes when patients were meticulously chosen during the initial disease stages before the onset of collapse.