Prospective Observational Study on the Functional and Radiological Outcome of Core Decompression with Bone Marrow Aspirate Concentrate in Osteonecrosis of Femoral Head

Abstract

Background: Osteonecrosis of the Femoral head is one of the most serious morbidity and several treatment methods are available for treating osteonecrosis. Most of these procedures are effective only in the early stages before the collapse of the femoral head. Hence this study was planned to evaluate the effectiveness of bone marrow aspirate in conjunction with core decompression in modifying the progression of the disease.

Materials and methods: This prospective interventional study was conducted in a College in Chennai among 32 patients selected consecutively from August 2022 to August 2024 fulfilling the inclusion and exclusion criteria. The pre-and post-operative follow-up was performed using the Visual analog scale (VAS), Harris Hip Score (HHS), and Association Research Circulation Osseous (ARCO) classification. The data was collected using MS EXCEL and analyzed using SPSS version 21.

Results: We analyzed 32 patients with osteonecrosis of the femoral head. The mean age of the patients was 37.8±11.5 years and 59.4% were males. Alcohol consumption(46.9%) was the primary etiology for the disease and the left side(37.5%) was mostly affected in the patients. Over the 12 months of follow-up the VAS and HHS improved gradually which was statistically significant with p-value <0.05. There was no change in ARCO score pre- and post-operatively.

Conclusion: In most cases, using bone marrow aspirate concentrate and core decompression at the pre-collapse stages of the disease improves function scores, slows the disease's radiological development, and eliminates the need for a total hip replacement. Hence effective use of these procedures can prevent or delay surgical intervention among the patients.