THE PROGRAM OF REHABILITATION TREATMENT AFTER ORGAN-PRESERVING OPERATIONS FOR PATIENTS WITH ASEPTIC NECROSIS OF THE FEMORAL HEAD STAGE I-II ACCORDING TO ARCO

BACKGROUND: One of the promising approaches to surgical treatment of early-stage avascular necrosis of the femoral head (ANFH) involves procedures that include tunneling and intrafocal reconstruction of the femoral head using cell-based technologies. However, a comprehensive rehabilitation program following organ-preserving surgeries has not yet been developed.

AIM: To develop an integrated rehabilitation program for patients undergoing organ-preserving interventions for early-stage avascular necrosis of the femoral head, applicable to both early and late rehabilitation periods, and to assess its efficacy and safety.

METHODS: A prospective, single-center, observational, randomized, controlled, single-blind clinical study was conducted to compare the effectiveness of a newly developed rehabilitation program versus standard rehabilitation after organ-preserving surgery for patients with ARCO stage I–II avascular necrosis of the femoral head.

RESULTS: . The study included 59 patients aged 24 to 58 years with ARCO stage I–II ANFH. The surgical protocol was based on an original technique that combined minimally invasive multiplanar intrafocal decompressive tunneling with bone autoplasty and PRGF (Plasma Rich in Growth Factors)–mediated cell stimulation, followed by rehabilitation measures. Patients were randomly allocated into two groups: the intervention group, which received the new rehabilitation program, and the control group, which received standard rehabilitation. Clinical data were collected before treatment and at the completion of the inpatient phase of late postoperative rehabilitation. The study period was January 2020 to December 2024. Following treatment (surgery plus rehabilitation), both groups demonstrated positive outcomes. The most significant finding was the difference in the progression rate of ANFH according to MRI and radiography. At 12 months, signs of femoral head collapse were observed in 25% of joints in the intervention group compared with 32.3% in the control group.

CONCLUSION: The widespread implementation of a structured rehabilitation program for both early and late recovery phases after organ-preserving surgery for ARCO stage I–II avascular necrosis of the femoral head may improve treatment outcomes and enhance overall quality of life in this patient population.