Osteonecrosis Of The Femoral Head Research Articles

Alcohol consumption is a recognized risk factor for osteonecrosis of the femoral head (ONFH), as well as hypertension, and malignant tumors. Aldehyde dehydrogenase 2 (ALDH2) activity influences alcohol-associated risks by modulating acetaldehyde metabolism; however, its role in ONFH remains unclear. This study aimed to investigate whether the alcohol flushing response, a proxy for ALDH2, modifies the relationship between alcohol consumption and ONFH. A hospital-based case-control study was conducted on newly diagnosed patients with ONFH and controls recruited. Information on alcohol flushing responses was collected using a self-administered questionnaire and categorized into current/former flushers (inactive ALDH2) and never flushers (active ALDH2). Odds ratios (OR) and their 95% confidence intervals (CI) of various levels of alcohol consumption (habitual drinking, heavy drinking, and drinking of ≥320 g/week) were assessed for ONFH using a logistic regression model. Stratified analysis and multiplicative interaction were used to investigate the effect modification by the alcohol flushing response on the association between alcohol consumption and ONFH. A total of 118 cases with ONFH and 213 controls were included (mean age, 45 years; 197 men and 134 women). The adjusted ORs of alcohol consumption for the development of ONFH were 1.5 (95% CI: 0.4-6.0) and 3.7 (0.3-41.3) for habitual drinking, 1.6 (0.4-5.6) and 2.0 (0.1-24.2) for heavy drinking, and 3.8 (0.8-17.6) and 4.5 (0.4-49.2) for drinking of ≥320 g/week among current/former and never flushers, respectively. No significant multiplicative interactions were observed. Alcohol flushing response may not modify the relationship between alcohol consumption and the risk of ONFH.

Osteonecrosis of the femoral head (ONFH), driven by glucocorticoid-induced M1 macrophage polarization and disrupted inflammatory homeostasis, poses a critical challenge in orthopedics. Here, we engineered adipose-derived mesenchymal stem cell exosomes (ADMSC-Exos) via metabolic glycoengineering (MGE) to deliver α2-macroglobulin (A2M), generating DS-exo@A2M. This nanoconstruct synergistically suppressed M1 polarization ( ↓ TNF-α, ↓IL-6) and promoted M2 polarization (↑CD206, ↑Arg-1) in M1 macrophages through IL-4 signaling activation, evidenced by transcriptomic/proteomic profiling and shRNA-mediated IL-4 knockdown. DS-exo@A2M further enhanced osteogenic differentiation of bone marrow-derived mesenchymal stem cells (BMSCs) by upregulating RUNX2, ALP, and OCN. In a rat ONFH model, DS-exo@A2M restored trabecular architecture ( ↑ BV/TV, ↓Tb.Sp) and reduced bone marrow edema. Mechanistically, IL-4 silencing abolished DS-exo@A2M-mediated macrophage reprogramming and osteogenesis, confirming pathway specificity. This study establishes a precision nanotherapeutic strategy for ONFH by integrating exosome engineering, immunomodulation and biosafety assessment, offering a translational framework for treating inflammation-associated bone disorders.

ABSTRACT Background Osteonecrosis of the femoral head (ONFH) is a debilitating condition characterized by bone tissue necrosis due to vascular insufficiency, often triggered by corticosteroid use. Steroids are commonly employed in the management of autoimmune diseases, organ transplantation, and COVID-19. Early detection is crucial, as ONFH primarily affects young and middle-aged individuals and often progresses to femoral head collapse if untreated. Objective To evaluate the protective effects of Apelin-13 (Ap-13) on steroid-induced ONFH (SONFH) in a rat model. Methods Thirty-two female Sprague-Dawley rats were randomized into four groups: Control, Ap-13 only, ONFH, and ONFH + Ap-13. SONFH was induced using lipopolysaccharide (LPS) and methylprednisolone (MPS). The treatment group received daily intraperitoneal Ap-13 injections. At the fourth week, radiological, histopathological, immunohistochemical, and biochemical analyses were conducted on femoral heads. Results Micro-CT showed no significant differences in bone mineral density or trabecular parameters. Histopathology revealed increased osteonecrosis, empty lacunae, and vascular thrombosis in the ONFH group, which were significantly reduced in the ONFH + Ap-13 group (p < 0.05). Ap-13 decreased serum malondialdehyde (MDA) levels (p = 0.0002), reduced caspase-3 expression (p < 0.05), and elevated VEGF expression (p = 0.046), indicating reduced oxidative stress, apoptosis, and enhanced vascularization. Additionally, LDL and triglyceride levels were significantly lower in the Ap-13 treated group (p < 0.05). Conclusion Apelin-13 demonstrates protective effects against SONFH by reducing oxidative stress, apoptosis, and improving vascularization. It may represent a promising noninvasive therapeutic strategy for early-stage ONFH.

Aseptic osteonecrosis of the femoral head (ONFH) is a debilitating orthopedic disorder that predominantly affects young adults and has a multifactorial etiology. In mining-intensive regions such as Katanga (Democratic Republic of the Congo), chronic exposure to trace metal elements (TMEs) has raised concerns about potential environmental contributors to bone disease. This study aimed to investigate the association between bone TME accumulation and the occurrence of idiopathic ONFH in an environmentally exposed population. A case-control study was conducted between 2017 and 2025 at Medpark Clinic, Lubumbashi. Femoral head specimens were collected from 56 patients undergoing total hip arthroplasty, including 36 cases of idiopathic ONFH and 20 controls with primary osteoarthritis. Bone concentrations of eleven TMEs (Pb, Co, Cd, Cr, Zn, Cu, As, Mn, Mg, Ni, Al) were quantified using inductively coupled plasma-optical emission spectrometry (ICP-OES). Exposure was defined as a Z-score > 2 compared with a local reference population. Bivariate and multivariate logistic regression analyses were performed to assess associations. Patients with ONFH were significantly younger than controls (mean age: 49.5 vs. 62.9 years; p = 0.004). Bone concentrations of lead and cobalt were markedly higher in ONFH cases. In multivariate analysis, elevated bone lead levels (adjusted OR = 23.75; 95% CI: 2.30-181.57) and age ≤ 50 years were independently associated with ONFH. No significant associations were found for other TMEs. This study provides the first direct evidence that chronic bone accumulation of lead and cobalt is strongly associated with idiopathic ONFH in a mining-exposed African population. These findings highlight the urgent need for environmental monitoring, targeted public health interventions, and early clinical surveillance in high-risk regions.

Background: Osteonecrosis of the femoral head is a progressive disorder leading to femoral head collapse and early disability, often affecting young adults. Core decompression (CD) is the most established hip-preserving treatment for early-stage disease, yet the comparative benefits of biological and structural augmentation remain uncertain. Methods: This systematic review and meta-analysis, registered in PROSPERO (CRD420251108396), evaluated 14 studies encompassing 1210 patients treated with CD alone or CD combined with biological (e.g., platelet-rich plasma, mesenchymal stem cells, bone marrow aspirate concentrate) or structural (e.g., bone grafting, fibular support) augmentation. Results: Pooled random-effects models demonstrated that biological augmentation yielded significant improvements in Harris Hip Score and pain reduction (VAS) up to 24 months, with early peaks and subsequent stabilization, whereas structural augmentation showed no functional advantage at any time point. Radiological progression and conversion to total hip arthroplasty were not significantly reduced, though long-term trends favored biologically augmented CD. Conclusions: Overall, biological augmentation provides durable functional and symptomatic benefits in early-stage osteonecrosis, supporting its use as a first-line adjunct to CD, while structural augmentation appears less consistent and warrants further evaluation through large, standardized trials.

Outcomes of Core Decompression With Allograft-Bone Threaded Cage or Mineralized Collagen Threaded Scaffold for the Treatment of Early-Stage Osteonecrosis of the Femoral Head: A 10-Year Follow-Up.

Efficacy of stem cell therapy for avascular necrosis of the femoral head: A systematic review and Meta-analysis.

BackgroundOsteonecrosis of the femoral head (ONFH) is a challenging global health issue with an unclear pathogenesis, complicating the development of effective treatment strategies. Bone marrow edema (BME) is a critical imaging indicator of ONFH progression, yet its underlying mechanisms remain poorly understood.MethodsBioinformatics was employed to identify gene characteristic of BME in ONFH patients. Expression of PTGS2 was validated in these patients through Western blot and ELISA assays. Clinical relevance was assessed by analyzing the correlation between PTGS2 expression levels and pain severity as well as the timing of total hip replacement surgery. In addition to GSE74089, we externally validated PTGS2 in an independent GEO cohort (GSE123568, human serum; GPL15207) using single‐gene receiver operating characteristic (ROC) analysis.ResultsSix hundred and eighty‐eight overlapping targets were identified for ONFH and BME, with 15 key targets shared with XLGBC, including PTGS2, IGFBP3, MCL1, TNF, F7, PLA2G4A, PRKCA, MMP1, and PTGER3. GO and KEGG enrichment analyses indicated that XLGBC exerts its effects mainly through pathways related to inflammation, pain, angiogenesis, and bone metabolism, notably involving VEGF signaling, arachidonic acid metabolism, and MAPK pathways. Molecular docking revealed strong binding between XLGBC compounds and the target genes. ELISA results indicated that higher PTGS2 levels correlated with increased pain severity in ONFH patients, and Western blot analysis showed significantly elevated PTGS2 in ONFH patients compared to controls, with levels decreasing after XLGBC treatment. Patients with higher PTGS2 expression showed shorter times to hip replacement surgery, suggesting faster disease progression. In the external cohort (GSE123568), PTGS2 showed good diagnostic discrimination for ONFH versus controls (AUC = 0.86), supporting the robustness of our bioinformatics findings.ConclusionsPTGS2 is an important gene in ONFH with BME, influencing pain and disease progression. Monitoring PTGS2 expression may help to assess symptom severity and inform surgical timing in ONFH patients.

Exploring the link between brucellosis and osteonecrosis: A scoping review of current evidence.

Immune checkpoint inhibitors (ICIs) have dramatically reshaped the therapeutic landscape of oncology, offering long-term survival benefits across multiple tumor types. However, ICIs are associated with a broad range of immune-related adverse events (irAEs), most of which are now well characterized and manageable. A subset of irAEs, however, remains rare, unpredictable, and poorly understood, both in terms of clinical presentation and pathogenesis. Here, we describe the case of a patient with advanced melanoma treated with combined anti-CTLA-4 and anti-PD-1 therapy who developed severe left hip pain during treatment. Imaging findings were initially suggestive of osteonecrosis of the femoral head. However, histopathological analysis of the resected femoral head revealed a dense lymphoplasmacytic infiltrate with fibrosis and vascular congestion, without evidence of bone necrosis, consistent with an immune-mediated osteitis. To our knowledge, this represents the first documented case of direct immune-related inflammation selectively affecting bone tissue during ICI therapy. Recognition of such atypical skeletal irAEs may be critical for improving diagnosis and management strategies in the expanding field of immuno-oncology.

Osteonecrosis of the femoral head (ONFH) is a serious and not uncommon complication in several autoimmune diseases. There is limited research and understanding of ONFH in idiopathic inflammatory myopathies (IIM). To investigate the prevalence, clinical characteristics, and predictive factors of ONFH in IIM. An observational cohort study. We retrospectively enrolled 1464 IIM patients, who were classified into ONFH and non-ONFH groups. Independent predictors of ONFH were identified by logistic regression and incorporated into a prediction model. Model performance was assessed using receiver operating characteristic curve, the Hosmer-Lemeshow test, calibration curves, and decision curve analysis. The prevalence of ONFH was 5.9% (86/1464) in IIM. Notably, almost half (52.3%, 45/86) tested positive for anti-melanoma-differentiation-associated gene 5 (MDA5) antibodies in patients with ONFH. Pulse or high-dose glucocorticoids (>1 mg/kg/d) (G) (OR: 2.857, 95%CI: 1.769-4.613), anti-MDA5 antibodies (A) (OR: 3.546, 95%CI: 2.140-5.876), muscle weakness (M) (OR: 1.968, 95%CI: 1.154-3.356), periungual erythema (P) (OR: 2.198, 95%CI: 1.229-3.931), and hyperlipidemia (H) (OR: 4.784, 95%CI: 2.827-8.095) were identified as independent risk factors for ONFH. To better predict ONFH, a nomogram model was constructed, demonstrating good discrimination with an AUC of 0.798 (95% CI: 0.747-0.849). For rapid risk assessment, a simplified scoring model was developed and designated as "GAMPH", with an AUC of 0.797 (95% CI: 0.747-0.848). ONFH is not a rare complication of IIM, particularly among patients positive for anti-MDA5 antibodies. This study provides a promising clinical tool for identifying IIM patients at risk of developing ONFH.

We present a rare presentation of bilateral hip arthropathy secondary to Dianzani autoimmune lymphoproliferative disease (DALD) that was managed with simultaneous bilateral cementless total hip arthroplasties (THAs). A 34-year-old female patient presented with a history of generalized joint pain and bilateral hand deformities. Her treating rheumatologist acknowledged that the patient was diagnosed with a rare autoimmune disease, DALD, for which she received immune-modulating drugs and steroids as management. She presented in January 2024 with bilateral hip pain; her functional score as per the Harris Hip Scoring (HHS) system was 34.5 and 34.2 for the right and left hips, respectively. The radiographs revealed bilateral hip arthropathy associated with bilateral osteonecrosis of the femoral head. After consultation with her treating rheumatologist and the anesthesiologist, her hip condition was managed by bilateral cementless THA performed in the same setting. At the last follow-up (11 months postoperatively), her functional scores improved significantly (HHS were 87 and 83.7 for the right and left hips, respectively), and the radiographs showed proper component positioning. This case presents a rare autoimmune disease (DALD) that led to bilateral hip arthropathy, which was treated successfully by bilateral THA. Collaborating with other specialties to ensure accurate patient diagnosis and management is paramount.

Introduction: Osteonecrosis of the Femoral Head (ONFH) is one of the common refractory diseases. However, the role of cuproptosis in ONFH pathogenesis remains unexplored. This study aimed to investigate the potential relationship between cuproptosis and ONFH. Methods: ONFH-related datasets were obtained from the Gene Expression Omnibus (GEO) database, and cuproptosis-related genes in the GSE123568 dataset were identified through differential expression analysis. To further discover potential cuproptosis-related biomarkers, Least Absolute Shrinkage and Selection Operator (LASSO) regression analysis and Support Vector Machine (SVM) analysis were conducted. The Receiver Operating Characteristic (ROC) curve analysis was used to explore the diagnostic value of cuproptosis-related biomarkers. The summary Statisticsbased Mendelian Randomization (SMR) algorithm was used to investigate the causal relationship between the related genes and ONFH. The immune infiltration analysis was conducted to assess the effect of immune cells on ONFH. Subsequently, the GSE74089 and GSE89587 datasets were used to validate gene expression levels and predict the lncRNA-miRNA-mRNA network. Finally, quantitative Real-Time Polymerase Chain Reaction (qRT-PCR) was employed to validate the expression of these genes. Results: The study showed that the upregulation of PDHB, a cuproptosis-related biomarker, may contribute to the development of ONFH. Additionally, immune cells were found to play a crucial role in ONFH, and PDHB showed a significant association with various immune cells. Furthermore, the study identified the existence of the MIR22HG/let-7c-5p/PDHB regulatory pathway, which may play a critical role in ONFH through cuproptosis. Discussion: This study discovered a cuproptosis-related regulating pathway, MIR22HG/let-7c- 5p/PDHB. This can provide new insights into the treatment of ONFH. However, further experimental validation is needed. result: This study showed that upregulation of the cuproptosis-related biomarker, PDHB, could lead to ONFH. At the same time, the study found that immune cells play an important role in ONFH, and PDHB is significantly associated with a variety of immune cells. The study also found the existence of MIR22HG/let-7c-5p/PDHB regulatory pathway, which may play an important role in ONFH through cuproptosis Conclusion: PDHB, identified as a cuproptosis-related biomarker, can induce ONFH through cuproptosis. PDHB also contributes to the pathogenesis and progression of ONFH by influencing immune cell function. This is most likely mediated through the regulatory interaction between MIR22HG, let-7c-5p, and PDHB.

Background: Legg–Calvé–Perthes disease (LCPD) is a pediatric osteonecrosis of the femoral head in which surgical containment aims to maintain femoroacetabular congruence and facilitate spherical remodeling. Femoral and pelvic osteotomies are established options, but optimal selection—particularly in older children or severe deformity—remains debated. Objective: To synthesize comparative evidence on outcomes, indications, and complications of femoral versus pelvic osteotomy, and selective combined procedures, in children with LCPD. Methods: A PRISMA 2020–guided search of MEDLINE, Embase, Scopus, Web of Science, Cochrane CENTRAL, and publisher platforms (2008–2025) included pediatric studies (4–12 years) reporting ≥24-month outcomes after femoral, pelvic, or combined osteotomies. The primary outcome was radiographic result at latest follow-up (Stulberg I/II vs III–V); secondary outcomes included range of motion, pain/functional scores, complications, reoperation, and hip survival/THA. Given heterogeneity, a narrative synthesis was performed; study quality was appraised using MINORS and considered qualitatively in interpretation. Results: Twelve studies met criteria. Across appropriately selected patients, femoral and pelvic osteotomies yielded broadly similar radiographic containment and functional improvement. Femoral osteotomy was favored in younger children, particularly lateral pillar B/B–C; pelvic osteotomy was preferred in older children with acetabular deficiency or hinge abduction. Combined osteotomy was reserved for severe multiplanar deformity, offering at most modest incremental benefit with greater operative complexity and higher complication exposure. Common sequelae included mild limb-length discrepancy and abductor weakness after femoral procedures, and overcoverage/impingement risk after pelvic reorientation; hip survival correlated more with age and severity than with technique. Conclusion: Procedure choice should be phenotype-driven, prioritizing age, lateral pillar status, and the dominant locus of deformity. Standardized, prospective comparative cohorts with patient-reported outcomes and survivorship endpoints are needed to refine algorithms and evaluate 3D planning–assisted strategies.

BackgroundOsteonecrosis of the femoral head (ONFH) is a prevalent and refractory hip disease. In this study, we investigated the expression profiles of lipid metabolism-related genes in ONFH and evaluated the potential therapeutic effects of squalene epoxidase (SQLE) and its inhibitors.MethodsDexamethasone was used to establish an in vitro ONFH model in MC3T3-E1 cells. Differentially expressed genes (DEGs) in the model group were identified through transcriptome sequencing. Lipid metabolism-related DEGs were extracted from GeneCards, and hub genes were determined via a protein–protein interaction (PPI) network. The expression patterns and diagnostic value of these hub genes were further validated using the GEO dataset. qRT-PCR and WB were performed to detect the expression of hub genes. Subsequently, the effects of SQLE knockdown and overexpression on osteoblast proliferation, apoptosis, and osteogenic differentiation were further evaluated. The involvement of ferroptosis was assessed by measuring Fe2⁺, ROS, MDA and GSH levels, with or without the ferroptosis inhibitor Fer-1. An in vivo rat model of ONFH was established. The therapeutic effects of SQLE inhibitors were evaluated by micro-CT, H&E staining, immunohistochemistry, serum lipid profiles, and ferroptosis-related indices.ResultsA total of 579 DEGs were identified, and these DEGs were enriched in various functions and pathways. After constructing the PPI network, five hub genes (Fdps, Lss, Sqle, Nsdhl, and Hmgcs2) were identified. GEO dataset validation confirmed consistent expression trends and diagnostic value for these genes. In vitro, SQLE knockdown significantly alleviated MC3T3-E1 damage, and mitigated ferroptosis-related oxidative stress. Conversely, SQLE overexpression aggravated these effects. In vivo, terbinafine treatment improved bone microarchitecture, reduced empty lacunae, normalized serum lipid profiles, and suppressed ferroptosis markers in ONFH rats.ConclusionsThis study reveals the role of SQLE in ONFH. Targeting SQLE, either through genetic silencing or pharmacological inhibition, alleviates osteoblast dysfunction and bone loss, providing a potential therapeutic strategy for ONFH.Supplementary InformationThe online version contains supplementary material available at 10.1186/s13018-025-06305-x.

Mid-term Results of Core Decompression Combined With Bone Marrow Aspirate Concentrate (BMAC) Injection for Early Osteonecrosis of the Femoral Head: A Prospective, Pilot Study

PurposeMesenchymal stem cells (MSCs) and pyroptosis play an important part in steroid-induced osteonecrosis of the femoral head (SONFH). The present study aimed at the identification and analysis of MSC and pyroptosis-related biomarkers for the treatment of SONFH, as well as the elucidation of their biological mechanisms.MethodsThe present study first use the outliers in GSE123568 data set were removed by principal component analysis (PCA). Next, differentially expressed genes (DEGs) in GSE123568 were identified using different expression analysis. Then, immune infiltration analysis and Wilcoxon test were performed. Later, acquires the DE_MSCs between DEGs and MSC, and DE_PRGs between DEGs and PRGs score. After, the top 20 intersected genes were selected by overlapping the two related genes. Afterward, select characteristic genes and diagnostic genes. Finally, the function enrichment analysis, drug prediction, molecular docking, molecular dynamic simulation. Then, reverse transcription quantitative PCR (RT qPCR), Western blot analysis, and immunohistochemical staining were performed on the femoral head specimens separately. (The model group specimens are from necrotic femoral heads, while the control group specimens are from femoral heads of patients with femoral neck fractures).ResultsThe expression of FKBP8 and ANK1 was significantly lower in RT qPCR, western blot analysis, and immunohistochemical staining compared to the control samples. The expression of PTGS2 is actually higher.ConclusionsIn this study, FKBP8, PTGS2 and ANK1 were identified as the biomarkers of SONFH, providing a potential rationale for diagnosing and treating SONFH.Supplementary InformationThe online version contains supplementary material available at 10.1186/s40001-025-02920-w.

Steroid-induced osteonecrosis of the femoral head (SONFH) is a common and refractory orthopedic disorder, often resulting from prolonged or high-dose glucocorticoid use that impairs bone repair and vascularization. The critical impact of exosomes derived from bone mesenchymal stem cells (BMSCs) in bone regeneration has drawn increasing attention. In this study, we developed a novel type of exosomes derived from Magnesium-preconditioned BMSCs (Mg-Exos) and evaluated their therapeutic potential. In vitro experiments demonstrated that Mg-Exos effectively counteracted Dex-induced impairment in the angiogenic function of human umbilical vein endothelial cells (HUVECs) and the osteogenic differentiation of BMSCs. These findings highlight the promise of Mg-Exos as a potential cell-free therapeutic strategy for SONFH, acting through the concurrent enhancement of vascularization and bone formation. Consequently, this work lays a solid foundation for the future application of Mg-Exos in treating SONFH.

The clinical use of magnetic resonance imaging-based volumetric measurement for osteonecrosis of the femoral head (ONFH) is restricted by its complexity. This study aimed to identify a practical computed tomography-based imaging parameter as a reliable alternative to necrotic volume and to evaluate its ability to predict femoral head collapse. This retrospective study included 125 hips from 90 patients with ONFH and initial collapse of < 3mm. Four-dimensional ratios were examined for their association with necrotic volume using generalized estimating equation models. The parameter showing the strongest association was determined by comparing models with the Quasi-likelihood Information Criterion (QIC). Receiver operating characteristic curve analysis was then used to establish a cutoff value for predicting a necrotic volume of ≥ 30%, the threshold defined as severe in the Steinberg classification. This prognostic value of this cutoff for collapse (> 3mm) was tested with a robust Cox proportional hazards model. The coronal vertical diameter ratio (CVDR) showed the strongest association with necrotic volume, yielding the lowest QIC. A CVDR cutoff of 51% predicted a large necrotic volume (AUC 0.931). Hips with a CVDR ≥ 51% had a significantly higher risk of collapse compared with those with a CVDR < 51% (HR, 6.07; 95% CI, 3.25-11.34;P < 0.001).This predictive value was consistent across all Japanese Investigation Committee type subgroups. The CVDR represents a simple and reliable alternative to volumetric assessment.A cutoff of approximately 51% provides clinically useful risk stratification, and incorporating lesion location may further enhance predictive accuracy.

ABSTRACTObjectiveIf the appropriate internal fixation surgical method is not adopted for femoral neck fractures in young people, it may lead to serious consequences such as poor fracture healing and femoral head necrosis, affecting the quality of life and working ability of young people. Therefore, it is crucial to conduct in‐depth research on the internal fixation surgical methods. This study compared the therapeutic effects of triple cannulated screws combined with a bone graft sleeve for parallel implantation of DBM Crunch internal fixation (CCSBGS) and cannulated compression screws (CCS).MethodsMedical records on the young and middle‐aged patients with femoral neck fracture treated with two different internal fixation methods from January 2020 to June 2023 were collected and retrospectively analyzed in the Trauma Emergency Center of the Third Hospital of Hebei Medical University. Two internal fixation groups are: CCSBGS group with 50 patients, 35 males and 15 females, aged (42.44 ± 14.07) years; CCS group with 80 males and 39 females, aged (41.5 ± 13.48) years. This study compared the outcome measures of two groups of patients, including Garden alignment index, Operation duration time, Intraoperative blood loss, Length of hospital stay, Postoperative complications, Femoral neck shortening, Postoperative ambulation time, Walking with sticks, Barthel score, and Harris score.ResultsThere was a statistically significant difference in blood loss between the CCS group and the CCSBGS group; at the same time, the amount of bleeding in the CCS group was lower than that in the CCSBGS group (p < 0.01). During the follow‐up period, there was a statistically significant difference in the incidence of osteonecrosis of the femoral head among the two groups (p < 0.05), 20 patients in the CCS group and 2 patients in the CCSBGS group developed osteonecrosis of the femoral head. At the last follow‐up, the average degree of femoral neck shortening in the CCSBGS group [(0.49 ± 0.28) cm] was significantly lower than that in the CCS group [(0.87 ± 0.35) cm] (p < 0.05). Meanwhile, the postoperative ambulation time of the CCSBGS group is earlier than that of the CCS group (p < 0.05). In addition, the CCSBGS group had the highest Barthel scores [(95.50 ± 2.90)] (p < 0.05). The average Harris score in the CCSBGS group [(92.52 ± 2.41)] was higher than that in the CCS group [(90.47 ± 2.88)] (p < 0.05).ConclusionsCompared with CCSBGS and CCS, CCSBGS shows better efficacy in terms of quicker return to weight‐bearing activities, preservation of femoral neck length, reduction of the rate of osteonecrosis of the femoral head, and overall enhancement of hip function.