Platelet-rich plasma for the treatment of adolescent late-stage femoral head necrosis: a case report.

Osteonecrosis of femoral head (ONFH) is a disabling and intractable disease. Previous studies reported the increasing failure rates of total hip arthroplasty in younger patients, thus there should be special considerations for the adolescents. In this paper, we present a case of an adolescent female with late-stage glucocorticoid-induced ONFH (according to the Association Research Circulation Osseous classification system, Association Research Circulation Osseous IV). The patient received five consecutive ultrasound-guided intra-articular injections of platelet-rich plasma, and the therapeutic effects were assessed by visual analog scale, joint range of motion, Western Ontario and McMaster Universities Osteoarthritis Index, Harris Hip Score and magnetic resonance imaging. At 9-month follow-up, clinical and radiological reassessments demonstrated favorable outcomes. This case highlights the therapeutic potential of platelet-rich plasma injections for the late-stage ONFH, especially for adolescent patients.