Abstract

EARLY FUNCTIONAL RECOVERY AFTER PERCUTANEIOUS CORE DECOMPRESSION AUGMENTED BMAC IN FICAT STAGE III FEMORAL HEAD AVASCULAR NECROSIS: A CASE REPORT IN AN ADOLESCENT ATHLETE

Venkatesh Movva*, Anand Alluru, Syed Khaleel, Sunitha Manne Mudhu, Vijayalakshmi Venkatesan

Abstract

Background: Avascular necrosis (AVN) of the femoral head is a debilitating condition that commonly affects young individuals and may progress to femoral head collapse if untreated. Joint-preserving strategies are particularly important in adolescents to delay or avoid arthroplasty. Case Presentation: A 16-year-old male professional badminton player presented with chronic right hip pain for a duration of 11 months period duration. Clinical examination revealed restricted hip movements, an ectomorphic build, an antalgic gait, and Grade II tenderness over the anterior hip and medial groin region. MRI confirmed Ficat stage III AVN of the right femoral head. The patient underwent percutaneous core decompression augmented with bone marrow aspirate concentrate (BMAC). At 3-month follow-up, there was marked clinical and functional improvement in the pain. Pain, assessed using the Visual Analogue Scale (VAS), improved from 6/10 to 2/10, with restoration of normal gait. Hip flexion improved from 100° (painful) to 125° (mild pain), extension from 15° to 20°, and internal rotation from 10° to 30°. Muscle strength improved from 4/5 to 5/5 on the Oxford MMT scale. The patient successfully returned to sports activity. Conclusion: BMAC augmented core decompression may serve as an effective joint-preserving strategy in adolescent patients with mid-stage AVN, facilitating early recovery and return to high-demand activities.

Keywords: Avascular necrosis, percutaneous core decompression (PCD), Bone Marrow Aspirate concentrate, Femoral head.