Prospective Comparative Study of Bone Grafts Used in Avascular Necrosis of Femoral Head

grafting, vascularized grafting, and, in advanced stages, total hip arthroplasty (Fig. 1).Recent studies have focused on enhancing joint preservation techniques, such as the use of bone grafting and vascularized grafts, aiming to improve outcomes and delay or avert joint replacement, especially in younger patients. 1Alcoholism, corticosteroid exposure, and, more recently, post-COVID-19 sequelae, remain the most implicated etiologies, further underlining the need for early detection and individualized management of AVN.Ongoing research strives to elucidate the molecular mechanisms underpinning AVN, with hopes to guide the development of novel biologic and regenerative therapies in the future. Materials a n d MethodsThis was a prospective study of 30 patients with AVN of the femoral head who were treated with core decompression with bone grafting introduction Avascular necrosis (AVN), also termed osteonecrosis, is the pathological process characterized by cellular death of bone tissue resulting from an interruption of the blood supply, ultimately leading to bone collapse, pain, and progressive joint dysfunction. 1 The femoral head is most frequently affected by AVN, and the condition predominantly impacts young and middle-aged adults, with significant implications for mobility and quality of life.Risk factors for AVN are diverse and can be broadly categorized as traumatic and nontraumatic.Traumatic etiologies include fractures or dislocations of the femoral head, while nontraumatic causes prominently feature prolonged corticosteroid use, excessive alcohol intake, and chronic illnesses, such as sickle cell disease and systemic lupus erythematosus.Reports also indicate the rising importance of COVID-19 infection and its related treatment regimens as potential contributing factors for AVN, particularly following corticosteroid therapy for severe infection (Table 1).The pathogenesis of AVN involves a complex interplay among vascular compromise, impaired bone cell metabolism, and altered bone remodeling.In most cases, the process begins insidiously, with mild or intermittent pain in the hip or groin, which progressively worsens without timely diagnosis and management, eventually resulting in femoral head collapse if left untreated.Magnetic resonance imaging (MRI) is the preferred imaging modality for early identification, as it visualizes bone and marrow changes before plain radiographs become abnormal.Management strategies depend on the stage of disease and encompass both joint-preserving and reconstructive approaches, including core decompression, bone