الفهرس 
Introduction and Aim of the WorkOnly 14 pages are availabe for public view
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Abstract
Osteonecrosis continues to be a challenging disease to treat because the etiology remains unclear, and it often affects young patients who want to maintain an active lifestyle. In addition, osteonecrosis is a difficult pathologic entity to treat because of limitations of femoral head terminal blood flow and major biomechanical loads through the hip that can lead to collapse.
There are many treatment stratigies for ONFH, each treatment modality has its own merits and demerits and have different outcomes, therefore individualized selection of an appropriate treatment strategy for each patient is necessary according to age, sex, level of activity,stage of the disease and size of the lesion.
In this study, we aimed to evaluate the clinical and radiological outcome of core decompression and injection of concentrated bone marrow in the treatment of early stages of ONFH (ARCO stage I,II,IIIA).
Twenty patients with twenty six hips whom included in this study were diagnosed to have early stages of ONFH.
For all patients, conventional radiographs of the hip were done in two planes, MRI was done for all patients to determine site and size of the lesion. The Harris Hip Score was used for evaluation of the results of procedure pre and post-operatively. Patients were followed-up for twelve months after the operative procedure.
Mesenchymal stem cells in the concentrated bone marrow are believed to be essential in leading to the regeneration of bone in the AVN lesions, while the use of concentrated whole bone marrow, which includes other cells in the stromal and hematopoetic lineages, may also be critical to the therapeutic effect and the promotion of both osteogenesis and angiogenesis.
Augmentation procedures in core decompression surgery asappearing better options than performing more invasive procedures.
As regards our results in this study; we concluded that the patients that are candidate for core decompression and injection of concentrated bone marrow have the following criteria :
Age: young age (20-40 years)
Stage: early stages (ARCO I, II)
Early diagnosis
The majority of our patients were receiving corticosteroid therapy so we recommend close screening of these high risk patients with MRI which may show changes even before the patient clinical complaint
The primary limitations of the present study is that the follow up period is not enough to show the long term complications as the follow up period was 6 months to 1 year and limited number of patients.