Evaluating the Results of Corticocancellous Bone Autografting for Treatment of Femoral Head Osteonecrosis

The definite treatment option for osteonecrosis of femoral head (ONFH) is not clearly understood. In current prospective study, we investigated the outcomes of treatment of ONFH with corticocancellous bone autograft.Patients and 132 hips (96 patients) with ONFH ARCO type II and III were treated with corticocancellous bone autograft from the iliac crest. The pain intensity by numerical rating scale (NRS), range of motion and Harris hip score (HHS) were measured pre- and post-operatively and compared. The mean follow up was 48.5 ± 17.9 months. The progression of the disease was stopped in 120 hips (90.9%). In other 12 hips, the ONFH progressed. Total hip arthroplasty was performed for 10 of these patients. The pain severity decreased significantly (6.3 ± 4.1 vs. 1.4 ± 2) (p<0.001). Also, the range of hip motions and Harris hip score (35.8 ± 15.3 vs. 79.5 ± 16.2) increased significantly (p<0.001). Removing the necrotic bone and using corticocancellous bone autograft to fill the cavity can be used as an effective treatment method for patients with precollapse stages of ONFH. This technique also decrease the need for early THA.