KUMJ | VOL. 23 | NO. 5 | ISSUE 93 | DECEMBER, 2026

Mid-term results of Core Decompression and Stem Cell Therapy for Avascular Necrosis of Hip: A Retrospective Observational Cohort Study
Thapa J, Parajuli B, Dhoju D

Abstract:
Background Core decompression is a surgical procedure done in the early stage of avascular necrosis (AVN) of hip. The addition of bone marrow aspirate concentrate (BMAC) may enhance the outcome compared to the decompression alone. Objective To evaluates the midterm efficacy of core decompression with bone marrow aspirate concentrate in early-stage avascular necrosis of hip. Method This retrospective observational cohort study was conducted on 28 hips from 20 patients with MRI-confirmed avascular necrosis, Association Research Circulation Osseous (ARCO) stage I-IIIa of hip, treated with core decompression and bone marrow aspirate concentrate between 2017 and 2024. Functional outcome and severity of pain were assessed using modified Harris Hip Score (mHHS) and Visual Analogue Scale (VAS) respectively. Progression of the necrosis and the need for hip replacement were assessed in the regular follow-ups. Kaplan-Meier survival analysis was used to assess survival duration of the femoral head. Result The average mHHS improved from 57.65 ± 16.11 to 85.25 ± 10.86 (p < 0.001 at -34.67 to -20.52 confidence interval), and the average VAS decreased from 7.15 ± 1.31 to 2.10 ± 1.58 (p < 0.001 at 4.18-5.91 confidence interval). Five hips progressed to the next stage, out of which two required arthroplasty and three were on conservative management. Kaplan-Meier survival analysis showed 75% of the patients had their femoral head preserved for at least 70 months. Conclusion Core decompression augmented with bone marrow aspirate concentrate is a safe and effective treatment for early-stage avascular necrosis of the hip. It provides significant and rapid symptomatic relief, improves functional capacity, and demonstrates promising midterm survival of 75% in preventing femoral head collapse and delaying the need for total hip arthroplasty.
Keyword : Avascular necrosis of hip, Bone marrow aspirate, Core decompression