WCO IOF-ESCEO 2025: Combined Denosumab and Core Decompression Delay Conversion to Total Hip Arthroplasty in Femoral Head Osteonecrosis

Presenter: S.-Y. Lin

This retrospective study assessed denosumab’s effect on femoral head osteonecrosis (ONFH) in 53 patients (67 hips) undergoing core decompression over five years. 

Patients with Steinberg stage IIC or IIIC ONFH were divided into a denosumab group (n=32; two 60 mg doses postoperatively) and a control group (n=35). The primary outcome was time to total hip arthroplasty (THA); secondary outcomes included radiographic and functional progression. THA-free survival was higher with denosumab (87.5% vs. 64.71%), though not statistically significant (P=0.0821). Radiographic progression was similar. Subgroup trends favored stage IIC patients. 

Denosumab shows promise, warranting further randomized trials for confirmation.

World Congress on Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (WCO IOF-ESCEO 2025), April 10-13, 2025, Rome, Italy.