Role of Hip Arthroscopy in the Treatment of Avascular Necrosis of the Hip: A Systematic Review



1 Orthopedic Research Center, Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran

2 Tehran University of Medical Sciences, Tehran, Iran


Background: Avascular necrosis (AVN) or osteonecrosis of the femoral head occurs as a result of a vascular supply 
disruption that could lead to hip osteoarthritis. Recently, several joint-preserving procedures have been suggested to 
improve the outcome of AVN, including hip arthroscopy. This systematic review aimed to investigate the role of hip 
arthroscopy to preserve hip joints suffering from AVN.
Methods: This review was conducted to collect data on hip arthroscopy from the available literature for the management 
of AVN. The collected articles included those that were focused mainly on the management of AVN assisted by 
arthroscopy and published up to 2020 that were searched in four databases using such keywords as “Avascular 
Necrosis”, “AVN”, and “Osteonecrosis” in combination with “Hip Arthroscopy” or “Arthroscopic Hip Surgery”. 
Results: In total, 13 articles met the eligibility criteria, and no severe complications were reported after arthroscopy in 
patients with AVN. Moreover, the Harris scores were higher than 79 after the operation. The majority of the assessments 
showed that the use of arthroscopy was effective in the diagnosis and treatment of patients with AVN, except for one 
study, which had been performed on patients with stage IV AVN. 
Conclusion: The findings supported the idea that hip arthroscopy is effective in the treatment of AVN. This approach 
is becoming more popular for the diagnosis and treatment of hip disorders.
Level of evidence: I


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