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World J Orthop. Jun 18, 2026; 17(6): 116685
Published online Jun 18, 2026. doi: 10.5312/wjo.v17.i6.116685
Published online Jun 18, 2026. doi: 10.5312/wjo.v17.i6.116685
Letter to the Editor: Re-evaluating conservative hip preservation in osteonecrosis of the femoral head: Lessons from long-term follow-up
Xia Li, Hong-Ji Pu, Department of Medical Imaging, School of Stomatology, Affiliated Stomatological Hospital, Qujing University of Medicine and Health Sciences, Qujing 655000, Yunnan Province, China
Xia Li, Zhao-Wei Teng, The Second Affiliated Hospital of Kunming Medical University, Key Laboratory of Neurological and Psychiatric Disease Research of Yunnan Province, Yunnan Provincial Department of Education Gut Microbiota Transplantation Engineering Research Center, Kunming 650106, Yunnan Province, China
Co-first authors: Xia Li and Zhao-Wei Teng.
Author contributions: Li X, Teng ZW, and Pu HJ contributed to the conceptualization, design, intellectual construction and writing of the letter; Li X and Teng ZW contributed equally to this manuscript and are co-first authors. All authors read and approved the final version for publication.
Supported by National Natural Science Foundation of China, No. 82460289; and the Yunnan Provincial Health Commission - Yunnan Provincial Health Commission Medical Discipline Leader Training Program, No. D-2024018.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Corresponding author: Hong-Ji Pu, MD, Associate Professor, MBBS, Department of Medical Imaging, School of Stomatology, Affiliated Stomatological Hospital, Qujing University of Medicine and Health Sciences, No. 1 Longdong Road, Malong District, Qujing 655000, Yunnan Province, China. hongji_pu@sina.com
Received: November 24, 2025
Revised: January 6, 2026
Accepted: January 20, 2026
Published online: June 18, 2026
Processing time: 207 Days and 18.4 Hours
Revised: January 6, 2026
Accepted: January 20, 2026
Published online: June 18, 2026
Processing time: 207 Days and 18.4 Hours
Core Tip
Core Tip: This letter evaluates a study by Chen et al, describing conservative hip preservation in osteonecrosis of the femoral head. The study highlights a high hip-preservation rate and introduces the concept of “survival with collapse”, whereby radiographic progression does not equate to functional decline. This commentary emphasizes appropriate patient selection, radiological predictors, and the value of individualized non-surgical strategies in managing osteonecrosis of the femoral head.