A retrospective comparison of hyperbaric oxygen and core decompression for mild to moderate avascular necrosis of the femoral head

Abstract

JOURNAL/mgres/04.03/01612956-202603000-00001/figure1/v/2025-06-28T140100Z/r/image-tiff Avascular necrosis of the femoral head is a condition resulting from disrupted blood supply, leading to ischemia and bone tissue necrosis. Core decompression (CD) restores the blood supply through pressure relief, whereas hyperbaric oxygen (HBO) enhances tissue oxygenation and promotes bone repair. Their combined use may complement each other in improving blood supply, promoting bone healing, and inhibiting disease progression, thus achieving a better therapeutic effect. To assess and compare the efficacy of HBO and/or CD for treating mild to moderate femoral head avascular necrosis, a retrospective study was conducted on patients diagnosed with Ficat stage II non-traumatic osteonecrosis between January 2017 and January 2022 at the Affiliated Central Hospital of Shenyang Medical University, China. A total of 72 patients were divided into HBO, CD, and combination groups, with 24 patients in each group. After 1 year of follow-up, 90% of patients in the HBO group, 85% in the CD group, and 95% in the combination group showed satisfactory improvements in hip joint function. The SF-36 quality of life questionnaire scale scores also significantly improved in all three groups, with the combination group showing the most significant improvement. These findings suggest that HBO offers promising potential for treating non-traumatic femoral head necrosis, with efficacy similar to that of CD. The combination group showed the most significant improvement in both hip joint function and quality of life.

Keywords: Ficat classification; clinical practice; combination therapy; core decompression; efficacy; hip joint function; hyperbaric oxygen therapy; non-invasive treatment; non-traumatic femoral head necrosis; quality of life.