Platelet-Rich Plasma Enhanced Bone Autograft in Femoral Head Necrosis-A Case Series Report on a Six-Year Follow-Up Period

Aim: We compared the long-term results of two treatment regimes in avascular femoral head necrosis. Methods: We performed a retrospective clinical observational study on 19 hips that were operated on by core decompression and autologous bone impaction enhanced with platelet-rich plasma (platelet-rich plasma+bone autograft group). As a control, 13 hips were operated on by core decompression only (decompression group). Joint replacement was evaluated as the primary endpoint of the study, functional results were evaluated according to the Harris Hip Score and bone density measurements were performed. Results: Prosthesis implantation was significantly less frequent in the platelet-rich plasma+bone autograft group than in the decompression group (p<0.05). In the platelet-rich plasma+bone autograft group, operated hip function at follow-up declined according to advancement of the preoperative Ficat stages. No specific pattern in the bone density scoring was identified between the groups analyzed. Conclusion: The combination of platelet-rich plasma with core decompression and autologous bone impaction may be an effective method in lowering the need for hip prosthesis implantation in the treatment of femoral head avascular necrosis.