Osteonecrosis of the femoral head. Results of core decompression and grafting with and without electrical stimulation.

The effectiveness of core decompression and bone grafting with and without electrical stimulation was investigated in patients with avascular necrosis (AVN) of the femoral head. One hundred sixteen hips with AVN had decompression and grafting; 74 were also treated with direct current (DC). The DC stimulation was via a coil inserted directly into the femoral head. These were compared to 55 hips with AVN treated nonoperatively. Hips treated with electrical stimulation showed less roentgenographic progression and achieved a better clinical score than hips treated with decompression and grafting alone. Both groups had a significantly lower incidence of arthroplasty than the nonoperated controls. One patient developed a pulmonary embolus, but there were no fractures or other complications. Decompression and grafting are safe and reasonably effective in retarding the progression of AVN. Supplemental electrical stimulation seems to improve the results even further.