Fig. 2

Radiographic sequence from a representative case of a symptomatic 44-year-old man with ONFH successfully treated with BMMC implantation. a Coronal T1-weighted MRI scans of the right hip before surgery show osteonecrotic lesion in Ficat IIB stage. The osteonecrotic lesion is surrounded by sclerotic low-signal margin (arrow) with subjacent marrow edema. b Anteroposterior X-ray radiograph showing minimally invasive decompression. The trephine was introduced under fluoroscopy through the greater trochanter into the femoral head. The BMMCs were injected through the trephine into the necrotic zone. c, d Twelve-month postoperative coronal (c) and axial (d) MRI (T1-weighted) scans after autologous BMMC implantation showing the channel, decreased bone edema and changes of signal in the superior part of the femur. Axial MR image (d) shows well-delimited marrow region of increased signal intensity (arrow) within the necrotic area and hypointense line around them due to reparative new bone. e, f Preoperative (e) and 60-month postoperative anteroposterior (f) radiographs of the same hip showing the femoral head has maintained the sphericity (arrow)