{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,2]],"date-time":"2025-11-02T07:09:23Z","timestamp":1762067363420,"version":"build-2065373602"},"reference-count":41,"publisher":"MDPI AG","issue":"19","license":[{"start":{"date-parts":[[2022,9,20]],"date-time":"2022-09-20T00:00:00Z","timestamp":1663632000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>We sought to determine whether multiple drilling (MD) combined with the injection of recombinant human bone morphogenetic protein-2 (rhBMP-2) and \u03b2-tricalcium phosphate (\u03b2-TCP) could improve survival of the femoral head in pre-collapse lesions of non-traumatic osteonecrosis of the femoral head (ONFH) as compared with MD alone. We conducted a single-site, off-label, comparative and prospective cohort study between November 2017 and May 2019. We enrolled 25 hips (25 patients) with non-traumatic ONFH (Ficat\u2013Arlet stage 2A or less). We performed a survival analysis, and the primary outcome was the occurrence of femoral head collapse on follow-up radiograph. Our cohort consisted of 11 men and 9 women of age 52.5 \u00b1 8.8 years and a body mass index of 24.3 \u00b1 3.0 kg\/m2. The femoral heads were preserved in 9 hips (45.0%) and collapsed in 11 hips (55.0%) at the final follow-up; mean survival to collapse was 6.9 (range 2.8\u201313.5) months. There were no significant differences in the survival of the femoral head between the MD alone group and the MD with rhBMP-2 and \u03b2-TCP group (five hips survived, 50% vs. four hips survived, 40%, respectively; p = 0.83). MD combined with the injection of rhBMP-2 and \u03b2-TCP did not improve femoral head survival compared to MD alone in the pre-collapse non-traumatic ONFH lesion.<\/jats:p>","DOI":"10.3390\/jcm11195499","type":"journal-article","created":{"date-parts":[[2022,9,20]],"date-time":"2022-09-20T22:36:44Z","timestamp":1663713404000},"page":"5499","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Multiple Drilling with Recombinant Human Bone Morphogenetic Protein-2 in Korean Patients with Non-Traumatic Osteonecrosis of the Femoral Head: A Prospective Randomized Pilot Study with a Minimum Two-Year Follow-Up"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4713-4036","authenticated-orcid":false,"given":"Jun Young","family":"Park","sequence":"first","affiliation":[{"name":"Department of Orthopedic Surgery, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin 16995, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7472-4103","authenticated-orcid":false,"given":"Byung Woo","family":"Cho","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul 06273, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2924-280X","authenticated-orcid":false,"given":"Hyuck Min","family":"Kwon","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Severance Hospital, Yonsei University College of Medicine, Seoul 03722, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Woo-Suk","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul 06273, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kwan Kyu","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Severance Hospital, Yonsei University College of Medicine, Seoul 03722, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,9,20]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2165","DOI":"10.2106\/JBJS.I.00575","article-title":"The natural history of untreated asymptomatic osteonecrosis of the femoral head: A systematic literature review","volume":"92","author":"Mont","year":"2010","journal-title":"J. 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