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Treatment of stage I and II osteonecrosis of the femoral head with core decompression and bone marrow aspirate concentrate injection—A 2-year follow-up study

Abstract Introduction Osteonecrosis of the femoral head (ONFH) is a rapidly progressive degenerative disease typically affecting individuals in their fourth to fifth decade of life. Treatment modalities for ONFH range from non-invasive interventions, including electrical stimulation and pharmacological agents, to surgical procedures, such as core decompression (CD) with bone marrow aspirate concentrate (BMAC) injection. The objective of this study was to determine if BMAC improved patient-reported outcomes and successfully prevented the need for total hip arthroplasty (THA) in patients with ARCO Stage I–II ONFH. Materials and methods Fifty-two patients (29 males, 23 females, and 66 hips) with stage I-II ONFH and an average age of 40 years (range: 17–67) were treated with CD and BMAC between January 2010 and 2013. All procedures were performed by a single surgeon (TAE) using a standardized technique. Patients were prospectively followed for an average of 2 years and evaluated at baseline, 6, 12, 18, and 24 months postoperatively with the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Short Form 12 (SF-12), and the EuroQol 5 dimensions (EQ-5D) questionnaires. Results At an average of 2-years follow-up, patients reported significant improvements in all WOMAC subcategories ( p p p Conclusions The goals of treatment for ONFH are to preserve function, reduce pain, and delay the need for THA. Our study has demonstrates that CD-BMAC may be a worthwhile treatment modality in patients with stage I or II ONFH. However, future randomized control trials comparatively evaluating the effectiveness of CD-BMAC to a control are necessary to better understand the clinical impact associated with BMAC therapy.