Early results in the treatment of avascular necrosis of the femoral head with electrical stimulation.

Our goal in the treatment of avascular necrosis is to retard or reverse the progressive changes that normally take place and thus preserve rather than replace the femoral head. "Conservative" or nonoperative management has generally proved unsuccessful, and results with established surgical procedures have been inconsistent and frequently disappointing. A new approach has been described that uses direct-current stimulation in conjunction with bone grafting and decompression. Results were determined clinically and radiographically using a new method of staging and evaluation. The majority of patients who underwent surgery showed significant clinical improvement, especially in regard to pain relief. Some degree of radiologic progression, however, was detected in most cases, even in many with clinical improvement. Electrical stimulation, as used in this study, did not appear to alter the results obtained with decompression and grafting alone. It must be emphasized that this is a preliminary report. More data and longer follow-up will be required before definitive conclusions can be drawn, and we must continue our efforts to improve the management of avascular necrosis.