The Initial Experience With Core Decompression and Reversed Autologous Bone Grafting for Post-COVID-19 Avascular Necrosis of the Femoral Head in Central India

Avascular necrosis (AVN) of the femoral head has emerged as a significant complication following the coronavirus disease 2019 (COVID-19) pandemic, affecting a relatively young patient population. Core decompression with reverse autologous bone grafting is a key joint-preserving surgical technique. This technical report describes our single-center experience and illustrates the application of this technique in a series of post-COVID-19 AVN cases. This retrospective technical assessment was conducted at a single center in Nagpur, central India, spanning from January 2022 to December 2023. The study included 101 hips (55 patients) who underwent the core decompression procedure utilizing reversed autologous bone grafting. The report describes the operative steps, specific surgical pearls, and technical challenges encountered during this unique approach in post-COVID-19 AVN patients. The procedure demonstrated favorable short-term outcomes, with patients showing statistically significant postoperative improvements in pain, functional mobility, gait stability, and overall mobility, as measured by Harris Hip Scores (p<0.0001). The technique of core decompression with reversed bone grafting is a viable and effective strategy for treating AVN of the femoral head in the post-COVID-19 era. This report offers practical insights into the application and efficacy of the technique, serving as a procedural guide for other orthopedic centers.