Functional outcomes of core decompression and autologous cancellous bone grafting with and without platelet rich plasma in early avascular necrosis of head of femur

Background: Early diagnosis and management of avascular necrosis (AVN) is of paramount importance in order to preserve the femoral head. Early intervention, if implemented at the pre-collapse stage, has favourable impact on the prognosis of disease. This study was conducted to compare the functional outcome of core decompression and autologous cancellous bone grafting with and without platelet rich plasma in early avascular necrosis of head of femur and to evaluate the complications associated with the procedure. Methods: It was a comparative, and prospective study. After obtaining ethics committee approval, total 30 hips (19 patients) divided randomly into two groups for treatment, as per inclusion and exclusion criteria. Group A (core decompression with autologous cancellous bone grafting with PRP), and group B (core decompression with autologous cancellous bone grafting without PRP). Assessment of the results, was based on the Harris hip score (HHS) and visual analogue scale (VAS) at preoperative, 2 weeks, 4 weeks, 6 weeks and 3, 6, and 9 months post-operatively. Results: There was no statistical difference seen between two groups in terms of distribution of cases based on age, gender, side, duration of symptoms, etiology, Ficat-Arlet grade, and surgical time. Mean HHS and mean VAS was found to be comparable in two groups postoperatively at all follow ups. Excellent to good results were obtained on functional assessment by HHS grading at final follow up of 9 months in patient treated under group A while patients treated under group B showed good to fair results. Both groups showed statistically significant improvement in HHS grade at 9 months as compared to preoperative HHS. In both groups, there was a statistically significant improvement in mean VAS at 9 months as compared to preoperative VAS. Conclusions: When combined with core decompression and bone grafting, PRP produces better HHS/functional outcomes as compared to core decompression and bone grafting alone for the treatment of early avascular necrosis of head of femur.