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Background <p>Osteonecrosis of the femoral head (ONFH) is a debilitating condition often leading to total hip arthroplasty (THA). Core decompression with fibular bone allograft is a promising technique to delay THA, especially in younger patients. This study evaluates the effectiveness of core decompression with fibular bone allograft in preserving the femoral head in ONFH patients.</p> Methods <p>A systematic literature review was conducted using PubMed and Scopus. From 662 articles, 5 studies were included, encompassing 311 patients (373 hips) with a mean age of 37.27&#xa0;years and an average follow-up of 85.53&#xa0;months. Outcomes analyzed included Harris hip scores, THA incidence, clinical and radiological success, and complications.</p> Results <p>Steroid use was the leading cause of ONFH in 50% of cases. Four studies reported significant improvements in Harris hip scores. THA incidence was 8.5 and 34.5% at 4 and 14&#xa0;years of follow-up, respectively. Clinical success ranged from 38 to 88%, and radiological success from 31 to 70%. Complications were rare, occurring in 1.9% of cases (6 instances).</p> Conclusions <p>Core decompression with fibular bone allograft is a low-cost, technically simple procedure that achieves high patient satisfaction, minimal complications, and favorable clinical outcomes. It is a viable option for preserving the femoral head and delaying THA in ONFH patients, particularly younger individuals.</p>

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Evaluating Core Decompression with Fibular Bone Allograft in Osteonecrosis of the Femoral Head: A Systematic Review

  • 期刊论文

  • 发表日期：

    2026年1月3日

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  • Omid Shahpari,
  • Seyed Sadegh Shirdel,
  • Seyyed Abolfazl Ghadiri,
  • Amirsaleh Abdollahi,
  • Mehran Frouzanian,
  • Mostafa Shahrezaee

摘要

Background

Osteonecrosis of the femoral head (ONFH) is a debilitating condition often leading to total hip arthroplasty (THA). Core decompression with fibular bone allograft is a promising technique to delay THA, especially in younger patients. This study evaluates the effectiveness of core decompression with fibular bone allograft in preserving the femoral head in ONFH patients.

Methods

A systematic literature review was conducted using PubMed and Scopus. From 662 articles, 5 studies were included, encompassing 311 patients (373 hips) with a mean age of 37.27 years and an average follow-up of 85.53 months. Outcomes analyzed included Harris hip scores, THA incidence, clinical and radiological success, and complications.

Results

Steroid use was the leading cause of ONFH in 50% of cases. Four studies reported significant improvements in Harris hip scores. THA incidence was 8.5 and 34.5% at 4 and 14 years of follow-up, respectively. Clinical success ranged from 38 to 88%, and radiological success from 31 to 70%. Complications were rare, occurring in 1.9% of cases (6 instances).

Conclusions

Core decompression with fibular bone allograft is a low-cost, technically simple procedure that achieves high patient satisfaction, minimal complications, and favorable clinical outcomes. It is a viable option for preserving the femoral head and delaying THA in ONFH patients, particularly younger individuals.