Efficacy of Core Decompression alone in Early-Stage Avascular Necrosis of the Femoral Head

Background: Avascular necrosis of the femoral head (AVNFH) is a progressive musculoskeletal disorder that can cause substantial disability due to collapse of the articular surface, primarily affecting young, active adults and posing significant socioeconomic challenges. The purpose of the study was to evaluate the efficacy of core decompression alone in patients with early-stage avascular necrosis of the femoral head. Methods & Materials: This prospective observational study at the Department of Orthopedics, Rangpur Medical College Hospital, Rangpur, and Sadar Hospital, Lalmonirhat, Bangladesh (July 2021–June 2025), included 30 patients with early-stage AVN (Ficat–Arlet I–II) undergoing core decompression. Demographics, HHS, radiological outcomes, and complications were recorded; data were analyzed using SPSS 26.0, with mean ± SD, frequencies (%), and paired t-tests for HHS changes (p < 0.05). Results: Among 30 patients (mean age 24.8 ± 4.0 years; 23 males), 14 had bilateral hip involvement. Etiology included steroid-induced AVN in 14, idiopathic in 10, and alcohol-related in 6 cases. Mean Harris Hip Score improved significantly from 58.4 preoperatively to 84.6 at 12 months (p < 0.001), with 22 patients achieving good-to-excellent outcomes. Radiologically, 24 hips remained stable or improved, while 6 progressed. Postoperative complications were minimal: mild pain in 8 patients, early femoral head collapse in 2, and no femoral neck fractures. Conclusion: Core decompression alone is a safe and effective treatment for early-stage avascular necrosis of the femoral head, providing significant functional improvement and radiological stability.