MINIMALLY INVASIVE APPROACHES IN THE TREATMENT OF AVASCULAR NECROSIS OF THE FEMORAL HEAD: EFFECTIVENESS AND PROSPECTS

Abstract Avascular necrosis (AVN) of the femoral head is a debilitating condition characterized by the loss of blood supply to the bone, leading to the collapse of the femoral head and subsequent joint destruction if left untreated. The management of AVN has evolved significantly, moving from traditional surgical interventions like total hip arthroplasty (THA) to minimally invasive and regenerative approaches that aim to preserve the native joint, reduce complications, and enhance recovery. This review provides a comprehensive analysis of the current and emerging strategies for the treatment of AVN, highlighting the efficacy and safety profiles of minimally invasive approaches such as core decompression combined with biological augmentation therapies like platelet-rich plasma (PRP), bone marrow aspirate concentrate (BMAC), and stromal vascular fraction (SVF). Traditional surgical interventions, such as THA and hip resurfacing, remain the gold standard for advanced AVN, offering excellent pain relief and functional restoration. However, they are associated with higher complication rates, longer recovery times, and potential need for revision surgeries, especially in younger patients. Comparative analysis suggests that minimally invasive approaches, particularly when combined with regenerative therapies, provide substantial benefits in early to mid-stages of AVN, delaying or even preventing the need for THA. Future directions in the management of AVN focus on innovations in regenerative medicine, including advanced stem cell therapies, gene editing, tissue engineering, and novel minimally invasive techniques enhanced by robotics and augmented reality. The development of biomarkers for early detection, personalized treatment approaches using artificial intelligence, and the integration of machine learning in clinical decision-making are also promising areas for advancing AVN care. This review emphasizes the need for ongoing clinical research to optimize these emerging therapies and develop tailored strategies that improve patient outcomes and quality of life.