This substance is taken by injection and as it is rapidly excreted from the body, Norgesic consumers have to reinjection it every 3 or sellectchem 4 hours to prevent withdrawal symptoms. Although Norgesic has high euphoria but it is rapidly excreted from the body and patients need to inject it frequently. In a study in Iran, the most common complication in heroin users was abscess on injection site and in Norgesic users was endocarditis. 37.5% of admitted patients in Norgesic group died. 70% of patients had fever when they were accepted for treatment and half of them had tachycardia and tachyphea.7 High prevalence and increasing consumption of these substances in society and subsequent osteonecrosis that mostly leads to exchange of hip joint with artificial joints, not only regarded as major surgery but also impose very heavy costs on patients.

On the other hand, high prevalence of young adults and bilateral involvement impose large economic burden on society. The Only successful treatment for advanced stage of osteonecrosis is exchange of joints. Since many cases of osteonecrosis are found in the young people and they are not good candidates for arthroplasty, other methods such as core decompression are also suggested6,8 and cases with complete recovery of avascular necrosis of femoral head following core decompression were reported in high stages. All of these methods have the best outcome when they are done in early stage of osteonecrosis. Moreover, none of these studies were done about core decompression but other methods were 100% successful.

1,2,6,9 Considering the fact that core decompression method is less invasive, the aim of this study was to compare this method of total hip arthroplasty (THA). Methods In this study, 27 cases of avascular necrosis of femoral head after taking Temgesic and Norgesic took part from 2008 to 2010. Three cases due to the simultaneous existence of lupus and one case due to Hodgkins�� lymphoma were excluded from study. Finally, 23 cases (29 joints) were studied for the final evaluation and follow-up. Patients were examined in terms of age, sex, duration of drug use, frequency of drug injection, the interval between being symptomatic and admission of surgery, involved side, involvement of other joints, coexistence of striae, simultaneous underlying disease, type of surgery, and method of drug taking.

Patients were randomly divided into 2 treatment groups. Since all patients under study were in stage 3 and 4 of FICAT, there was the same proportion of patients with 3 and 4 FICAT in both groups. It means that the involvement rate of femoral head and other features were the same in the two groups and just the type of treatment was different Cilengitide in these groups. Patients were clinically evaluated on the basis of functional scoring hip before surgery and after surgery.8 This grading consists of three sections and each section has six scores.