Osteonecrosis of the femoral head (ONFH) is a disorder that can lead to femoral head collapse. Various procedures have been advocated to avert the need for
total hip replacement. These include vascularised and non-vascularised
bone grafting procedures. We examined the effect of core
decompression combined with an allogeneic,
antigen-extracted, autolysed fibular allograft and autologous impacted
bone grafting for the treatment of
osteonecrosis of the femoral head. The study included 162 patients (223 hips; 61 females, 101 males; mean age 33.5 years, range 19-54 years) with stage II-III avascular
necrosis of the femoral head according to the
ARCO (Association Research Circulation Osseous) classification. The outcome was determined by changes in the Harris hip score, by progression in radiographic stages, and by the need for hip replacement. The mean follow-up was 24 months (range 7- 42 months). Statistical evaluation included Kaplan-Meier survival analysis. The mean Harris hip score increased from 61 to 85. Excellent and good results were obtained in 93.3% of cases in stage II, and 87% in stages III with a survivorship of 81% in all cases. Core
decompression combined with an allogeneic,
antigen-extracted, autolysed fibular allograft and autologous impacted
bone grafting may be the treatment of choice, particularly in the precollapse stage.