Device-assisted surgical treatment of avascular necrosis of the femoral head: Innovative approaches and clinical effectiveness

Avascular necrosis (AVN) of the femoral head is a debilitating condition predominantly affecting young, active individuals. Traditional surgical approaches such as total hip arthroplasty (THA) face limitations due to prosthetic lifespan and functional restrictions. This study evaluates the clinical efficacy of an innovative device-assisted surgical technique designed to restore femoral head integrity, reduce pain, and improve function. Objective: To assess the outcomes of a minimally invasive surgical protocol combining core decompression, vascularized bone grafting, and dynamic external fixation in patients with ARCO stage II–III AVN. Methods: A prospective cohort study was conducted, including 150 patients aged 20–60 years with ARCO stage II–III AVN. The surgical technique involved core decompression, necrotic tissue resection, vascularized bone grafting, and dynamic external fixation. Outcomes were evaluated through pain reduction (VAS), functional improvement (HHS), radiological healing, and complications over a follow-up of 36 ± 6 months. Data were analyzed using SPSS (version 26.0). Results: Pain scores improved significantly from 8.2 ± 1.1 to 2.4 ± 0.7 (p < 0.001). Harris Hip Scores increased from 42.5 ± 8.7 to 87.4 ± 5.2 (p < 0.001). Radiological analysis showed complete healing in 74% and partial restoration in 20%. Complications were minimal, with only 10% experiencing minor pin-site infections. Conclusion: The proposed surgical technique is a promising alternative for managing AVN, demonstrating significant pain relief, functional recovery, and structural restoration. Its low complication rate and cost-effectiveness make it an attractive option for younger, active patients.