# A New Horizon in Hip Health: Using an Innovative Variable Loop Curette for Core Decompression and Bone Marrow Aspirate Concentrate in the Management of Pre-collapse Avascular Necrosis of the Hip

## TL;DR

This case report explores a new surgical technique using a variable loop curette to treat early-stage hip osteonecrosis, showing improved patient outcomes and potential to delay hip replacement.

## Contribution

The paper introduces an innovative curette technique for core decompression and BMAC infusion in pre-collapse avascular necrosis.

## Key findings

- The patient experienced significant pain relief and improved hip function after the procedure.
- The technique shows promise in preserving hip function and delaying the need for total hip arthroplasty.
- Early-stage avascular necrosis may benefit from this approach, potentially limiting disease progression.

## Abstract

Avascular necrosis (AVN) of the femoral head, or osteonecrosis (ON), is a debilitating condition characterized by disrupted blood supply to the hip joint, leading to subchondral bone necrosis, joint collapse, and arthritis. Emerging evidence suggests that the long-term use of corticosteroids, particularly in the context of COVID-19 treatment, may contribute to AVN development.

This case report presents a male in his 50s with bilateral hip pain and a history of corticosteroid use. The patient underwent core decompression (CD) with a bone marrow aspirate concentrate (BMAC) infusion using the innovative curette technique.

Postoperatively, he followed a structured rehabilitation protocol and experienced significant pain relief and improved function. Reviewing existing literature, CD with BMAC using innovative curettes emerges as a promising approach for pre-collapse AVN management, preserving hip function, and delaying the necessity for total hip arthroplasty (THA). This case highlights the potential benefits of this technique in early-stage AVN, emphasizing its role in improving functional outcomes and limiting disease progression.