From radiological stability to functional preservation: Reconsidering the value of conservative treatment for osteonecrosis of the femoral head

Conservative treatment for osteonecrosis of the femoral head has long been debated due to inconsistent outcomes and limited clarity regarding its appropriate indications. The in-press study provides valuable long-term evidence demonstrating that radiological stability can translate into meaningful functional preservation in selected patients. This editorial re-examines the clinical value of conservative hip preservation by linking imaging-based progression patterns with long-term functional trajectories. Key considerations – such as stage-specific evaluation, patient selection, and predictors of treatment durability – are highlighted to refine clinical decision-making. A deeper understanding of the interaction between imaging stability and functional outcomes may reshape future treatment algorithms for osteonecrosis of the femoral head.