Evaluation of the mid-term clinical and mrg outcomes of core decompression surgery in the treatment of adult femoral head avascular necrosis

Objective: The aim of this study is to retrospectively examine the clinical and radiological outcomes of patients with femoral head avascular necrosis (FHAVN) who underwent core decompression surgery at our clinic between January 2022 and January 2024. The study aims to evaluate the effectiveness of surgical intervention in early-stage FHAVN cases and analyze the functional status of patients before and after surgery. Additionally, the study examines etiological factors that contribute to the progression of the disease, as well as the impact of external factors such as COVID-19. Materials and Methods: This retrospective study includes 40 patients who underwent core decompression surgery for femoral head avascular necrosis between January 2022 and January 2024 and were followed up for at least six months. Patients were evaluated using the Harris Hip Score (HHS) and the ARCO staging system before and after surgery. Demographic data (age, gender), smoking and alcohol use, history of COVID-19 infection, and comorbidities were also analyzed. Clinical recovery and radiological findings of the patients were recorded during a follow-up period of at least six months postoperatively. Results: The study included 40 patients, 64.1% of whom were male and 35.9% female, with a mean age of 49.71 ± 9.36. The mean preoperative Harris Hip Score was 73.51 ± 7.26, which increased to 97.18 ± 8.03 at the 6-month follow-up after surgery. These results indicate a significant improvement in hip function. None of the patients in ARCO Stage 1 preoperatively showed disease progression postoperatively. However, 17.4% of Stage 2 patients progressed to Stage 3 after surgery. Seventy percent of the patients had a history of COVID-19, with varying outcomes in terms of recovery, and some experienced disease progression. Conclusion: Core decompression surgery was found to be an effective treatment method for improving hip function, particularly in early-stage FHAVN patients. In patients with early-stage (Stage 1) FHAVN, disease progression could be halted. However, some progression was observed in Stage 2 patients after surgery.