Evaluation of Results of Core Decompression and Bone Marrow Injection in Treatment of Avascular Necrosis of Femoral Head

Introduction & Avascular necrosis of femoral is one of the complexities in orthopedic surgery. In advanced cases, the treatment is more straight forward but in early stages the goal is the preservation of head of femur. However there is no agreement with regard to the method. Decompression and drilling with one of bone grafting methods is used with variable results. In this study, decompression and drilling with bone marrow injection, aspirated from iliac crest is investigated. Finally 18 patients (23 hips) were included in study. Inclusion criteria were: stage 1 or 2 of avascular necrosis of femoral head, no previous operation on the involved hip and the age under 50. Drilling to subchondral bone and injection of bone marrow from iliac crest was done. Then in 3 and 6 and 12 weeks and 6 and 12 months after operation radiography from hip joint was done and evaluated for signs of collapse and destruction of joint. Results were evaluated with fisher test. A large number of patients who had stage 2 at the beginning of study (18 hips) showed collapse in about 6 months after operation (16 hips 88%). But patients at stage 1 had better results and showed destruction after 12 months of follow up (1 hips 20%). It seems (after evaluation of the results with fisher test) that drilling and bone marrow injection can not prevent progression of disease even in primary stages of the disease.