Finite element analysis of core decompression with ceramic rod implantation in osteonecrosis of the femoral head during the peri-collapse stage

• Core decompression with ceramic rod implantation significantly reduces stress in the weight-bearing and necrotic areas of the femoral head during single-leg stance and walking push-off phase. • The procedure decreases femoral head collapse (displacement) compared to preoperative values, indicating effective support against further collapse. • Stress distribution is improved, with partial load transfer to the femoral calcar, alleviating local stress concentration. • Finite element analysis provides quantitative biomechanical evidence supporting the clinical use of ceramic rods in peri-collapse stage osteonecrosis.