Core decompression is the accepted method of treatment of early femoral avascular necrosis (AVN).
However, its result in advanced stage AVN is varied and it frequently ends up with artificial joint replacement.
The three femoral heads with AVN Ficat stage 2B/3 were treated with the core decompression procedure.
Menatetrenone, vitamins and minerals supplement was administered post operatively. The outcomes were
evaluated by Harris hip score, the combined necrotic angle of the involved area of the femoral head and Ficat
staging. At 24 months follow up, the Harris hip score was improved in all compared to that value at the pre
operative period. No hips showed any sign of femoral head further collapse or changing of AVN stage. In
conclusion, core decompression can be used in the treatment of advance stage AVN. Menatetrenone was given
in order to help with bone mineralization during healing stage after core decompression. When combined
both treatments together, the natural history of advanced stage AVN is modified and the natural hip joint is
preserved.

Keywords: Avascular necrosis, Femoral head, Core decompression, Outcome, Menatetrenone, Ficat stagin