HIP International最新文献

{"title":"Femoral elevation variability in direct anterior THA: mechanical assessment of a common table-integrated lift system.","authors":"Emma E Helgeson, Sandeep Yanamala, John J Kelly, Alexander Hooke, Michael J Taunton, Christopher V Nagelli, Mario Hevesi","doi":"10.1177/11207000261473867","DOIUrl":"https://doi.org/10.1177/11207000261473867","url":null,"abstract":"<p><strong>Background: </strong>The direct anterior (DA) approach for total hip arthroplasty (THA) is increasingly used by surgeons. Although Hana traction tables are commonly used in DA THA, no study has quantified the mechanical performance and uniformity of the femur lift. Characterising femoral lift variability is clinically important for patient safety during femoral exposure.</p><p><strong>Purpose: </strong>To assess whether femoral lift velocity differs across increasing loads, femur lift laterality, and table age.</p><p><strong>Methods: </strong>7 Mizuho OSI Hana traction tables (14 actuators) were tested using a custom jig and loads between 25 and 100 lb. Lift velocity was measured over 10-second intervals, with 3 averaged trials per weight per actuator. A 2-way repeated-measures ANOVA was used to evaluate applied load and lift laterality, with Tukey post hoc comparisons conducted for significant effects. Pearson's correlation assessed the association between table age and lift velocity.</p><p><strong>Results: </strong>Lift velocity decreased with increasing load (25 lb: 6.42 ± 0.67 mm/second; 100 lb: 4.89 ± 0.50 mm/second; <i>p</i> < 0.01). No significant differences were observed between left (5.53 ± 0.80 mm/second) and right (5.78 ± 0.73 mm/second) actuators (<i>p =</i> 0.30). At equivalent load conditions, lift velocity differed by up to 39.4% between the fastest and slowest tables. Table age was not significantly correlated with lift velocity. All femur lifts successfully raised the maximum load of 100 lbs through full range of motion.</p><p><strong>Conclusions: </strong>Femoral lift performance exhibited predictable, load-dependent behavior without evidence of mechanical failure or age-related decline in velocity.Our findings suggest that traction table mechanical underperformance is unlikely to be a major contributor to difficult femoral exposure during DA THA. Continued displacement under high loads highlights the importance of cautious manipulation to prevent injury.</p>","PeriodicalId":12911,"journal":{"name":"HIP International","volume":" ","pages":"11207000261473867"},"PeriodicalIF":1.3,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148840217","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Uncemented cervico-metaphyseal short stems in selected proximal femoral deformities: long-term outcomes without adjunctive osteotomy.","authors":"Marcos Raúl Latorre, Fernando Diaz Dilernia, Carlos Lucero, Pablo Ariel Slullitel, Gerardo Zanotti, Fernando Martín Comba, Martín Alejandro Buttaro","doi":"10.1177/11207000261470072","DOIUrl":"https://doi.org/10.1177/11207000261470072","url":null,"abstract":"<p><strong>Background: </strong>Proximal femoral deformities (PFDs) pose a challenge due to complex anatomical alterations that often require demanding procedures with suboptimal outcomes. We hypothesised that uncemented short stems allow reconstruction without adjunctive osteotomies. This study aimed to evaluate long-term implant survivorship, clinical outcomes, and complication rates in patients with PFDs treated using an uncemented short stem.</p><p><strong>Methods: </strong>We retrospectively reviewed 35 hips in 31 patients with PFDs who underwent total hip arthroplasty between 2011 and 2018. Mean age was 44 years, and median follow-up was 131 months. We analysed whether an additional osteotomy was required, and assessed leg-length discrepancy (LLD) and femoral offset before and after surgery. Functional outcomes were measured using visual analogue scale (VAS) and the modified Harris Hip Score (mHHS). Implant survival and all complications were documented.</p><p><strong>Results: </strong>No patient required an additional femoral osteotomy. Both LLD and femoral offset improved significantly (<i>p</i> < 0.001). VAS and mHHS improved at last follow-up. 5 complications (14%) were recorded, with a stem survival rate of 97.1%.</p><p><strong>Conclusions: </strong>In carefully selected patients with proximal femoral deformities, uncemented cervico-metaphyseal short stems demonstrated durable long-term outcomes without the need for adjunctive femoral osteotomy in this series.</p>","PeriodicalId":12911,"journal":{"name":"HIP International","volume":" ","pages":"11207000261470072"},"PeriodicalIF":1.3,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148792265","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Do we need to use the largest possible size of the Proximal Femoral Nail Anti-rotation (PFNA) in well-reduced intertrochanteric fracture? A study of distal PFNA intramedullary canal occupying ratio (ICOR).","authors":"Saran Tantavisut, Chavarin Amarase, Napol Rattanasermsub, Sanzhar Artykbay, Supacheep Viriyakorkitkul","doi":"10.1177/11207000261466581","DOIUrl":"https://doi.org/10.1177/11207000261466581","url":null,"abstract":"<p><strong>Purpose: </strong>To assess the impact of the intramedullary canal occupying ratio (ICOR) on bone union and the stability of fixation in intertrochanteric fracture treatment using proximal femoral nail anti-rotation (PFNA) surgery.</p><p><strong>Methods: </strong>A retrospective analysis included 151 patients aged 60 years and above who underwent PFNA for unilateral intertrochanteric fractures between June 2020 and 2022. Patients were categorised into 3 groups based on ICOR percentiles (0.48-0.93). Bone healing was assessed using the Radiographic Union Score for Hip (RUSH) at 2, 6, and 12 weeks postoperatively. Fixation stability was assessed by comparing immediate and 3-month postoperative radiographs. Multivariate regression was used to assess the relationship between ICOR, RUSH scores, and fixation stability.</p><p><strong>Results: </strong>No significant differences in RUSH scores or stability measurements were found among the 3 ICOR-based groups. Multivariate regression showed no clear correlation between ICOR and RUSH scores, except for a statistically significant but not clinically relevant association with changes in neck-shaft angle. In contrast, RUSH scores were significantly associated with fracture severity according to the OTA/AO Classification.</p><p><strong>Conclusion: </strong>ICOR was not a significant predictor of fracture healing or fixation stability. In uncertain cases regarding nail size, using a smaller nail was not linked to inferior radiographic or fixation-related outcomes.</p>","PeriodicalId":12911,"journal":{"name":"HIP International","volume":" ","pages":"11207000261466581"},"PeriodicalIF":1.3,"publicationDate":"2026-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148766088","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The relationship between total hip arthroplasty and low back pain: a long-term perspective.","authors":"Francisco José Gallego-Peñalver, Silvia Beatriz Romero-de-la-Higuera, Eva María Gómez-Trullén","doi":"10.1177/11207000261466125","DOIUrl":"https://doi.org/10.1177/11207000261466125","url":null,"abstract":"","PeriodicalId":12911,"journal":{"name":"HIP International","volume":" ","pages":"11207000261466125"},"PeriodicalIF":1.3,"publicationDate":"2026-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148764859","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Periprosthetic strain-adaptive bone remodeling of conservative metaphyseal fitting versus conventional anatomic cementless femoral stem.","authors":"Young-Hoo Kim, Jang-Won Park, Young-Soo Jang, Eun-Jung Kim","doi":"10.1177/11207000261471326","DOIUrl":"https://doi.org/10.1177/11207000261471326","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to compare: (1) periprosthetic bone mass changes; (2) clinical results; (3) revision rates; and (4) survivorship of total hip arthroplasty (THA) in patients younger than 50 years.</p><p><strong>Methods: </strong>This was a retrospective study in which 168 patients with conservative metaphyseal-fitting anatomic cementless (CMA) stems (201 hips) were identified, and then a separate group of 181 patients with conventional anatomic cementless (CA) stems (209 hips) were identified. Periprosthetic bone mass change was measured using DEXA. The mean follow-up was 20-22 years (range 20-24 years) in both groups.</p><p><strong>Results: </strong>In the CA group, BMD decreased markedly in both Gruen zones 1 and 7 of the femur. Harris Hip Score, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score, and University of California, Los Angeles (UCLA) activity score improved significantly at the final follow-up in both groups. The survival rate was 97.5% (95% CI, 91-100%) in the CMA stem group and 97.1% (95% CI, 91-100%) in the CA group at 20 years of follow-up.</p><p><strong>Conclusions: </strong>At a mean follow-up of 20-22 years, both CMA and CA stems provided excellent clinical results. However, CA stems had significantly higher stress-shielding-related bone loss.</p>","PeriodicalId":12911,"journal":{"name":"HIP International","volume":" ","pages":"11207000261471326"},"PeriodicalIF":1.3,"publicationDate":"2026-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148757952","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acetabular fracture open reduction and internal fixation in patients under 60: time to total hip arthroplasty and implant survivorship: a systematic review.","authors":"Manikandar Srinivas Cheruvu, Sanjay Narayana Murthy, David Ford, Rohit Singh, Tosan Okoro, Niall Steele","doi":"10.1177/11207000261472062","DOIUrl":"https://doi.org/10.1177/11207000261472062","url":null,"abstract":"<p><strong>Aims: </strong>Acetabular fractures in young patients are usually treated with open reduction and internal fixation (ORIF) to preserve the native joint. Despite this, many develop post-traumatic arthritis, needing conversion to total hip arthroplasty (THA). The timing of THA and the long-term survival of these implants remain uncertain. We systematically reviewed the literature to determine the interval from ORIF to THA and to evaluate implant survivorship.</p><p><strong>Methods: </strong>We searched PubMed, Embase, Scopus, and Web of Science for studies reporting outcomes of patients <60 years who underwent ORIF for acetabular fracture and later THA. Data extracted on patient demographics, fracture type, time to THA, survivorship, and complications. Pooled estimates were calculated using random-effects models, and survivorship summarised using Kaplan-Meier methods.</p><p><strong>Results: </strong>12 studies including, ~450 patients met inclusion criteria. The pooled mean time from ORIF to THA was approximately 5.2 years (95% CI, 3.7-6.6). Between a ¼ and ⅓ of patients required THA at longer follow-up. Implant survivorship was 95% at 5 years and 85-90% at 10 years, declining to 70-80% at 15 years. Outcomes were worse in complex fracture patterns. Cementless fixation and modern porous ingrowth cups achieved survivorship similar to primary THA. Complications were more common than in primary THA, including dislocation (~10%), infection (~7%), and reoperation (~15%).</p><p><strong>Conclusions: </strong>In patients under 60, ORIF usually delays the need for THA by several years, but conversion is required in a substantial population. Conversion THA restores function and achieves acceptable survivorship, although it remains technically demanding, with higher complication rates than primary THA.</p>","PeriodicalId":12911,"journal":{"name":"HIP International","volume":" ","pages":"11207000261472062"},"PeriodicalIF":1.3,"publicationDate":"2026-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148712629","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk factors for wound complications in direct anterior total hip arthroplasty: a 10-year analysis.","authors":"Benjamin C Schaffler, Muhammad Haider, Amit Manjunath, Michelle Richardson, Roy Davidovitch, Matthew Hepinstall, Joshua Rozell","doi":"10.1177/11207000261467289","DOIUrl":"https://doi.org/10.1177/11207000261467289","url":null,"abstract":"<p><strong>Background: </strong>The purpose of this study was to identify risk factors associated with wound complications following DAA THA and to evaluate the incidence of these wound issues when negative pressure wound therapy (NPWT) was used as the primary surgical dressing.</p><p><strong>Methods: </strong>We reviewed 725 patients from five different surgeons at a single institution who underwent THA through a DAA from 2011 to 2023. Medical records were reviewed for demographics, comorbidities, surgical details, and a broad set of criteria denoting wound complications or dehiscence. Univariate and multivariate analyses were performed to identify potential risk factors. Secondary outcomes included periprosthetic joint infection (PJI), 90-day emergency room visits, readmission, and all-cause revision rates.</p><p><strong>Results: </strong>83 (11.4%) patients developed a wound complication based on criteria. Univariate analysis showed that increased body mass index (BMI) (mean 30.4 vs. 27.8, <i>p <</i> 0.001), surgical time (138.0 vs. 108.5 minutes, <i>p <</i> 0.001), hospital length of stay (50.4 vs. 40.6 hours, <i>p =</i> 0.013), DAA surgeon experience of less than 1 year (<i>p =</i> 0.012) and use of NPWT (25.3 vs. 11.6%, <i>p <</i> 0.001) were associated with wound complications. Multivariate analysis further demonstrated BMI (OR 1.06 [1.01-1.11] <i>p =</i> 0.016), longer surgical time (OR 1.01 [1.00-1.01] <i>p =</i> 0.004), and NPWT use (OR 2.1 [1.2-3.9], <i>p =</i> 0.016) as associated with higher rates of wound complications. Patients with wound complications had higher rates of 90-day emergency room visits (10.8 vs. 4.4%, <i>p =</i> 0.018), readmissions (15.7 vs. 3.9%, <i>p <</i> 0.001), all-cause revision (19.3 vs. 2.8%, <i>p <</i> 0.001) and PJIs (13.3 vs. 0.5%, <i>p =</i> 0.005).</p><p><strong>Conclusions: </strong>Obesity, length-of-stay, longer surgical time, and surgeon DAA experience <1 year were identified as risk factors for wound complications following DAA THA in our series. Prophylactic use of NPWT was not associated with a lower risk of wound complications in our cohort. Patients with wound complications had higher rates of PJI, readmission, and reoperation.</p>","PeriodicalId":12911,"journal":{"name":"HIP International","volume":" ","pages":"11207000261467289"},"PeriodicalIF":1.3,"publicationDate":"2026-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148712636","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk factors for failure following debridement, antibiotics, and implant retention (DAIR) in early periprosthetic joint infection after primary total hip arthroplasty.","authors":"Roni Serra Campos, Amanda S Cavalcanti, Helano Jader Batista de Almeida, Jamila Alessandra Perini, Marco Bernardo Cury Fernandes, Juliana Arruda de Matos","doi":"10.1177/11207000261459970","DOIUrl":"https://doi.org/10.1177/11207000261459970","url":null,"abstract":"<p><strong>Introduction: </strong>In the event of early or haematogenous periprosthetic joint infection (PJI), the preferred treatment is debridement, antibiotics, and implant retention (DAIR), with reported cure rates ranging from 60% to 80%. Nevertheless, the performance of this surgical strategy and the factors associated with poorer outcomes remain unknown in the Brazilian population. This study aims to evaluate the effectiveness of DAIR in early PJI following total hip arthroplasty (THA) and identify factors linked to unfavourable clinical outcomes.</p><p><strong>Methods: </strong>This is a retrospective cohort study of patients who underwent primary THA between January 2011 and December 2017, developed early PJI, and were treated with DAIR with a minimum follow-up of 1 year. An unfavourable outcome was defined as infection persistence, recrudescence, recurrence, or the need for revision surgery.</p><p><strong>Results: </strong>A total of 83 hips were included in the study, with a DAIR success rate of 72.3%. <i>Staphylococcus aureus</i> was the most frequently identified pathogen (59.7%), and no pathogen-related factors were associated with outcomes. Patient-related independent risk factors for unfavourable outcome included pre-DAIR haemoglobin ⩽ 10 g/dL (OR [95% CI] = 6.26, 1.63-24.08; <i>p</i> = 0.008) while a lower Charlson Comorbidity Index (CCI), a validated score that quantifies patient comorbidity burden, ⩽1 (OR [95% CI] = 0.04, 0.00-0.32; <i>p</i> = 0.003) and primary osteoarthritis (OR [95% CI] = 0.23, 0.06-0.95; <i>p</i> = 0.042) were protective. A procedure-related factor associated with failure was primary and THA surgical time ⩾180 minutes (OR [95% CI] = 10.15, 2.54-40.56; <i>p</i> = 0.001).</p><p><strong>Conclusions: </strong>In this population, prognostic factors associated with DAIR outcomes were related to patient characteristics and features of the index procedure rather than to antibiotic therapy or DAIR itself. These findings may help refine patient selection for DAIR and highlight potentially modifiable factors - such as preoperative anaemia, that could reduce the risk of treatment failure following THA.</p>","PeriodicalId":12911,"journal":{"name":"HIP International","volume":" ","pages":"11207000261459970"},"PeriodicalIF":1.3,"publicationDate":"2026-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148706349","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Robotic-assisted versus conventional total hip arthroplasty in Crowe Type 3-4 developmental dysplasia of the hip: a single-centre retrospective comparative cohort study.","authors":"Murat Kezer, Kayhan Turan, İsmet Yalkın Çamurcu, Semih Ak, Onur Gültekin","doi":"10.1177/11207000261467654","DOIUrl":"https://doi.org/10.1177/11207000261467654","url":null,"abstract":"<p><strong>Aim: </strong>The aim of this study was to compare the radiographic accuracy, clinical outcomes, and complications of robotic-assisted total hip arthroplasty (rTHA) and conventional total hip arthroplasty (cTHA) in patients with Crowe type 3-4 developmental dysplasia of the hip (DDH).</p><p><strong>Methods: </strong>This single-centre retrospective comparative study included 38 patients with Crowe type 3-4 DDH who underwent total hip arthroplasty (THA) between 2016 and 2021 (20 rTHA, 18 cTHA). Clinical outcomes were evaluated using the Harris Hip Score (HHS). Acetabular cup inclination, anteversion, leg-length discrepancy (LLD), operative time, and complications were assessed at a mean follow-up of 32.0 ± 15.7 months in the rTHA group and 35.9 ± 19.0 months in the cTHA group.</p><p><strong>Results: </strong>Acetabular anteversion and inclination were comparable between groups (<i>p</i> = 0.099 and <i>p</i> = 0.231). The proportion of cups within the Lewinnek safe zone was higher in the rTHA group (90% vs. 77%), without statistical significance (<i>p</i> = 0.302). No significant differences were observed in postoperative LLD or HHS. Operative time was significantly longer in the rTHA group (109.7 ± 33.6 vs. 93.5 ± 21.3 minutes, <i>p</i> = 0.042). Complication rates were similar between groups (2 vs. 2 cases).</p><p><strong>Conclusions: </strong>rTHA and cTHA demonstrated comparable radiographic and clinical outcomes in Crowe type 3-4 DDH at short- to mid-term follow-up. Although rTHA showed a trend toward improved implant positioning, operative time was longer. Larger prospective studies are required to determine potential long-term advantages of rTHA in severe DDH.</p>","PeriodicalId":12911,"journal":{"name":"HIP International","volume":" ","pages":"11207000261467654"},"PeriodicalIF":1.3,"publicationDate":"2026-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148701184","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative study of core decompression with allograft and autologous bone marrow therapy plus alendronate versus classical bone graft alone in Ficat grade II-III avascular necrosis of the hip.","authors":"Ahmed Alkhuzai","doi":"10.1177/11207000261467948","DOIUrl":"https://doi.org/10.1177/11207000261467948","url":null,"abstract":"<p><strong>Background: </strong>Osteonecrosis of the femoral head (ONFH) is a progressive, debilitating condition caused by compromised blood supply, leading to bone cell death and femoral head collapse. Effective early-stage treatments remain limited.</p><p><strong>Aim: </strong>This study compared core decompression (CD) with allograft and autologous bone marrow therapy plus alendronate against classical bone grafting alone in patients with Ficat Grade II-III ONFH, aiming to assess functional outcomes and delay the need for total hip arthroplasty.</p><p><strong>Methodology: </strong>This randomised, prospective study involved 48 patients with Ficat Grade II-III avascular necrosis of the hip. Group A received CD combined with autologous bone marrow stem cells and allograft plus alendronate, while Group B underwent CD with a classical iliac bone graft and alendronate. Clinical outcomes were assessed at 6, 12, and 24 months using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Harris Hip Score (HHS), Oxford Hip Score (OHS), and magnetic resonance imaging-based necrotic area evaluation.</p><p><strong>Results: </strong>Over a 24-month follow-up, Group A demonstrated superior outcomes across all clinical indices. WOMAC scores improved from 36.9 to 12.2 in Group A, versus 34.7 to 22.4 in Group B. HHS rose from 45.8% to 82.0% in Group A and from 42.6% to 60% in Group B. OHS increased from 12 to 44 in Group A and from 14 to 28 in Group B. Significant (<i>p</i> < 0.0001) reductions in necrotic segment size and fewer poor outcomes were observed in Group A.</p><p><strong>Conclusions: </strong>Group A's approach yielded greater functional recovery, pain relief, and mobility restoration than classical grafting alone.</p>","PeriodicalId":12911,"journal":{"name":"HIP International","volume":" ","pages":"11207000261467948"},"PeriodicalIF":1.3,"publicationDate":"2026-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148701188","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}