COMPARATIVE STUDY BETWEEN CORE DECOMPRESSION WITH AND WITHOUT BONE MARROW ASPIRATE INJECTION IN PATIENTS WITH FEMORAL HEAD OSTEONECROSIS

Abstract

Introduction: Osteonecrosis of the femoral head (ONFH) results from insufficient vascular supply and may progress to femoral head collapse and degenerative changes. Core decompression (CD) is a common management for initial-stage disease, but its long-term benefit is debated. Bone marrow aspirate (BMA) has proposed as a biological adjunct to enhance bone regeneration. This study evaluates the clinical outcomes of CD with or without BMA in managing ONFH. Materials and Methods: A prospective cohort study was conducted with patients suffering from ONFH. Hips were divided into 2 groups, first group managed by core decompression alone and the second group treated with core decompression with bone marrow injection .Outcome measures included visual analogue score for pain, Oxford Hip score and radiological evaluation. Results: 52 hips suffering from ONFH were included in the study. Twelve months postoperatively, significant pain reduction and functional enhancement were detected in the CD with BMA group, but not in the CD alone group. Conclusion: Core decompression augmented with bone marrow aspirate emerges as a distinctly promising, joint-preserving intervention delivering pain relief, improving hip function, and offering a more promising trajectory of recovery than core decompression alone in early to intermediate osteonecrosis (Ficat 1&2) of the femoral head. However, its efficacy diminishes with disease progression, highlighting the need for early detection and treatment