Endoscopic Assisted Core Decompression and Bone Graft for Osteonecrosis of the Femoral Head

Abstract

Aim: To evaluate the usefulness of endoscopy in core decompression and autogenous bone grafting for osteonecrosis of the femoral head (ONFH). Methods: Our study included 6 patients (7 hips) who underwent endoscopy with autogenous bone grafting between January 2013 to December 2015, and were followed up for more than 2 years. Among the 7 cases, 2 were Ficat & Arlet (F&A) stage I, 3 were stage II, and 2 were stage IIb. The patients included 4 men and 2 women, with an average age of 31 years (22-45 years). ONFH was steroid-induced in 3 cases and idiopathic in 3. Results: Among the 7 patients that underwent surgery, 5 showed improvement of clinical symptoms and radiographic results. Two cases with F&A stage IIb progressed to femoral head collapse, 1 of which required total hip arthroplasty. The endoscopic findings in the cases with progression of femoral head collapse showed a wide range of necrosis, making it difficult to observe healthy bone marrow with bleeding. Conclusion: This case series is small and the follow-up period was short. However, endoscopic assisted autogenous bone grafting during core decompression is effective for joint preservation in young patients with ONFH.