Precollapse femoral head avascular necrosis after combined surgical-medical management

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Updated: Mar 31, 2026

Augmented Reality Navigation-Guided Core Decompression for Osteonecrosis of Femoral Head
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Mahendra Solanki1, Abhishek Pal1, Swapnil Mathur1

  • 1Department of Orthopaedics, MGM Medical College, Indore, Madhya Pradesh, India.

Bioinformation
|March 30, 2026
PubMed

Insights

Early treatment combining surgery and medication for avascular necrosis of the femoral head (AVN) significantly improves hip function. This approach led to good or excellent outcomes in over 87% of hips, preventing collapse.

Area of Science:

  • Orthopedics
  • Regenerative Medicine

Background:

  • Avascular necrosis of the femoral head (AVN) involves bone death due to impaired blood supply, potentially leading to hip collapse.
  • Early intervention is crucial to prevent femoral head collapse in AVN patients.

Purpose of the Study:

  • To evaluate the efficacy of combined surgical and pharmacotherapy for precollapse AVN.
  • To assess functional outcomes and hip preservation in patients with early-stage AVN.

Main Methods:

  • Sixty patients (80 hips) with Ficat-Arlet stage I and IIA AVN underwent core decompression and iliac crest grafting.
  • A fixed 48-week pharmacotherapy protocol was administered concurrently.
  • Patients were followed for functional outcomes using the Harris Hip Score.

Main Results:

  • Significant serial improvement in Harris Hip Score was observed.
  • Unilateral hips achieved 87.5% good to excellent outcomes; bilateral hips reached 90%.
  • No hips progressed to a poor outcome category at final follow-up.

Conclusions:

  • Combined surgical (core decompression with grafting) and medical management provides significant short-term functional benefits for early-stage AVN.
  • Prompt treatment is essential for favorable outcomes in avascular necrosis of the femoral head.

Keywords:
Avascular necrosisBone TransplantationCore DecompressionFemoral headHarris Hip ScorePrecollapse stageSurgical

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