Trial reportInternational orthopaedics2026
In stage II osteonecrosis, bone grafting delays femoral head collapse compared with core decompression in glucocorticoid-associated osteonecrosis of the femoral head.
Trial report in International orthopaedics, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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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.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
1 citing paper in PubMed.
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Authors and funding
8 authors.
Funding
Abstract
purposeTo compare lesion debridement with bone grafting (LDBG) versus core decompression (CD) in preventing femoral head collapse in early glucocorticoid-associated osteonecrosis (GA-ONFH).
methodsThis single-center, superiority randomized controlled trial (Level I) enrolled 86 patients (18-60 years) with ARCO stage II GA-ONFH, randomized to CD or LDBG. PRIMARY OUTCOME: proportion maintaining ARCO stage II at 24 months. SECONDARY OUTCOMES: interval-specific progression to collapse (0-6, 6-12, 12-24 months) and Harris Hip Scores (HHS) among non-collapsed hips. Safety outcomes included perioperative blood loss, hospital stay, and surgery-related adverse events.
resultsOf 86 patients, 81 completed follow-up. At 24 months, ARCO stage II was maintained in 70% (28/40) of LDBG vs. 41% (17/41) of CD patients (P = 0.010; RR = 1.69; NNT = 4). CD had better HHS at six months (P < 0.001), but no difference at 12/24 months among non-collapsed hips. CD involved less blood loss (P < 0.001) and shorter hospital stays (P = 0.002); serious adverse events were similar (P = 0.72). Prespecified subgroup analyses showed consistent LDBG benefit, especially in females, patients with BMI < 23.9, high glucocorticoid dose, and non-manual occupations.
conclusionLDBG significantly reduces collapse risk versus CD in early GA-ONFH, with comparable mid-term function and safety, supporting its use as a preferred joint-preserving strategy, particularly for females, patients with lower BMI (< 23.9), high glucocorticoid exposure, and non-manual occupations.
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Registered trials
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