A comparative study on the clinical effectiveness of core decompression with bone grafting for treating alcohol-induced and traumatic osteonecrosis of the femoral head: a population-specific investigation in alcoholism.

Abstract

Abstract. Osteonecrosis of the femoral head (ONFH) is a debilitating ortho-pedic condition with two primary categories: traumatic osteonecrosis (TONFH) and non-traumatic ONFH, including alcoholic-induced osteonecrosis (AIONFH). Core decompression combined with bone grafting is a common treatment ap-proach, but its efficacy and influencing factors in these two categories remain unclear. We conducted a study involving 50 patients (25 TONFH, 25 AIONFH) who underwent this procedure. Demographic data and clinical assessments were collected. The average age was 47.2 years, with 72% males. AIONFH patients had a higher BMI and more comorbidities like diabetes, hyperlipidemia, hyperten-sion, and immune-related diseases. TONFH had a higher prevalence of osteopo-rosis and fracture history. Bilateral hip necrosis was more frequent in TONFH, while left hip necrosis dominated in AIONFH. Both groups mainly had JIC classi-fications C1 and C2. Preoperatively, most cases were ARCO grade III and IV, with lower Harris, PCS, and MCS scores. Both groups improved at the six-month post-operative assessment, with better results in AIONFH. The last follow-up was 16.62 months after treatment. In the final follow-up, AIONFH cases were mainly ARCO type I, and HHS, PCS, and MCS scores were significantly better than TONFH. Core decompression combined with bone grafting effectively treats AIONFH and TONFH, with superior outcomes in AIONFH. Factors influencing postoperative efficacy include BMI, JIC classification, and PCS score. These findings provide valuable insights for tailoring treatment strategies to specific ONFH categories.