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REVIEW article

Front. Surg.

Sec. Orthopedic Surgery

This article is part of the Research TopicAdvances in Precision Medicine for Minimally Invasive Treatment of Pelvis/Hip Fractures: Integration of Digital and Intelligent TechnologiesView all 9 articles

Role and Research Progress of Hip Arthroscopy in the Treatment of Pre-collapse Osteonecrosis of the Femoral Head

Provisionally accepted
Guangnian  LiuGuangnian LiuZijing  WengZijing WengHuazhang  XiongHuazhang XiongLi-Ming  DongLi-Ming Dong*
  • Zunyi Medical University, Zunyi, China

The final, formatted version of the article will be published soon.

Background: This study is to provide a detailed overview of the application value of hip arthroscopy in the treatment of pre-collapse ischemic necrosis of the femoral head (ONFH) and summarizes the latest research progress. Methods: Using the search string (("osteonecrosis of the femoral head" OR "avascular necrosis of the femoral head" OR ONFH) AND (hip arthroscopy OR arthroscopic)) in PubMed, we identified 69 records. After screening and exclusions, 54 studies were included in a comprehensive narrative review of ONFH and hip arthroscopy. The review focused on the application of hip arthroscopy in core decompression and head–neck fenestration grafting for ONFH, and summarized the management of concomitant intra-articular lesions and arthroscopy-related complications. Results: As a novel technique applied in the early stages of ONFH, hip arthroscopy remains in an exploratory phase. Current literature affirms its clinical effectiveness in treating early ONFH, highlighting advantages such as highly precise positioning, shorter surgical duration, rapid postoperative recovery, and minimal surgical trauma compared to traditional approaches. However, challenges arise due to the unclear surface landmarks for arthroscopic entry, leading to a prolonged learning curve and demanding a high level of technical expertise from surgeons. Simultaneously, satisfactory outcomes have been achieved in addressing intra-articular pathologies accompanying the hip joint, such as femoroacetabular impingement, synovitis, and joint effusion. Conclusions: This review provides a systematic description of the role of hip arthroscopy in ONFH and summarizes the latest clinical applications of hip arthroscopy and its shortcomings.

Keywords: Athroscopy, distraction, Treatment, Femoral head, Osteonecrosis

Received: 31 Mar 2025; Accepted: 27 Oct 2025.

Copyright: © 2025 Liu, Weng, Xiong and Dong. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Li-Ming Dong, dongliming777@163.com

Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.