Osteonecrosis of the femoral head at an early stage is still a challenge for the orthopaedic surgeon, especially considering that it often affects young patients (between the third and fifth decade of life). Total hip arthroplasty remains the gold standard treatment, although it is a drastic choice that doesn’t save affected joints. Various techniques have been proposed (arthrodiastasis, Mont technique, vascularized fibular transplant, core decompression in association with the implant of devices and/or growth factors) in order to save the femoral head. Starting from the idea of core decompression, we developed a new surgical technique with a dedicated instrumentation that involves the removal of necrotic tissue (core decompression), the implant of growth factors (rh-BMP-7) and an equine flexible bone scaffold enriched with autologous mesenchymal cells. The aim is to create a biological chamber within the femoral head, that is able to regenerate healthy bone tissue thanks to the fact that all the necessary elements are present. The technique seems to give good results, notably because of the short operating time, the simplicity of the surgical technique and the possibility to save a still healthy articulation in young, but already symptomatic, patients. This procedure can be performed in the operating room under fluoroscopic vision or, as presented in this case report, under CT guide, thus improving the accuracy of cell collection, decompression and grafting procedures.