A novel dual-tunnel Y-technique core decompression done for stage – 2 AVN femoral head

Avascular necrosis of the femoral head is a condition marked by the degeneration of the cellular structure of the subchondral bone due to a vascular compromise, ultimately resulting in arthritis. Core decompression, also referred to as CD, is well recognized as a successful treatment for early-stage osteonecrosis of the femoral head (ONFH). To alleviate pressure within the osseous cavity and facilitate reperfusion, CD is executed. The core decompression of the femoral head has been achieved by the application of several procedures that have been developed. This category of operations encompasses the lightbulb approach, trapdoor technique, use of conical reamers, bone grafting, percutaneous core decompression, and numerous more approaches. Some proposed modifications include the supplementary implantation of bone marrow cells, growth factors, fibular grafting, and the insertion of a tantalum implant. We offer a distinctive dual-tunnel Y-technique of core decompression, done for the first time in a single case of Grade-2 AVN hip, executed alongside the administration of BMAC into the tunnel. The novel dual-tunnel Y-technique for core decompression in early-stage avascular necrosis of the femoral head offers a minimally invasive approach that achieves adequate decompression of multiple necrotic regions through a single cortical entry. By enabling optimal delivery and distribution of bone marrow aspirate concentrate (BMAC) while minimizing cortical and soft tissue damage, this technique addresses some limitations of conventional methods. Its biomechanical advantage lies in preserving bone stock, reducing surgical morbidity, and potentially improving revascularization and bone healing.