ArticleCureus2025
Comparison of Core Decompression and Fibular Strut Graft in Early Avascular Necrosis of the Hip: Assessment of Postoperative Pain and Functional Outcomes.
Article in Cureus, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Abstract
introductionThere is limited local data comparing the outcomes of core decompression and fibular strut grafting in early-stage avascular necrosis (AVN) of the hip. International findings may not be directly applicable due to population-specific factors such as genetics, lifestyle, and healthcare access. Early identification of the optimal surgical option is essential for improving patient counseling, postoperative recovery, and overall clinical outcomes.
objectiveTo compare postoperative pain and functional outcomes of core decompression versus fibular strut grafting in patients with early-stage AVN of the hip. METHODOLOGY: This prospective, randomized comparative cohort study was conducted at the Department of Orthopedic Surgery, Khyber Teaching Hospital, Peshawar, from 14th March 2023 to 13th September 2023. A total of 112 patients aged 18-50 years with Ficat and Arlet stage I-II AVN were enrolled and equally allocated into the core decompression or fibular strut graft groups using blocked randomization. Postoperative pain was assessed at 12 weeks using the visual analog scale (VAS), with a score >3 considered significant. Functional status was evaluated using the Hip Disability and Osteoarthritis Outcome Score (HOOS). Data were analyzed using chi-square tests for categorical variables and appropriate tests for functional scores, with p ≤ 0.05 considered statistically significant.
resultsSignificant postoperative pain (VAS > 3) was observed in 11 (19.6%) patients in the core decompression group and 17 (30.4%) in the fibular strut graft group (χ² = 1.708, p = 0.190). Stratification by age, gender, and BMI consistently showed lower pain rates in the core decompression group, though differences were not statistically significant. HOOS functional scores demonstrated a similar trend favoring core decompression, but these differences also did not reach statistical significance.
conclusionCore decompression was associated with fewer patients experiencing significant postoperative pain and showed a trend toward better short-term functional outcomes compared to fibular strut grafting. Its minimally invasive nature may make it a preferable option for early pain management in patients with early-stage AVN of the hip. However, the lack of statistical significance and the short follow-up period warrant further studies with larger sample sizes and inclusion of long-term functional and radiological outcomes before definitive clinical recommendations can be made.
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