Objective To evaluate the outcome of targeted decompression and filled with β-TCP in the treatment of early and middle stage femoral head necrosis based on patient reported outcomes.Methods 23 patients (32 hips) who met the standard were enrolled. Preoperative Mimics software was used to reconstruct the necrotic area and design the decompression channel. According to the preoperative plan, Flipcutter was used to accurately debride in the necrotic area under the guidance of the independently designed guide device.The central decompression channel was prepared, the porous ceramic particles of β-TCP were suppressed into the original necrotic cavity and implanted into the bone repair bed with the porous ceramic rod of β-TCP. Incision and complications were observed. MRI examination was performed 2 years after surgery. Outcomes was evaluated by HOOS and sf-36 health survey scale.Results No serious complications occurred after the operation.Postoperative pain, symptoms, daily activity ability, sports, life quality of HOOS were improved significantly compared with preoperation. Physical function, Role-Physical, bodily pain, general health, vitality and role-emotional of SF-36 were improved significantly (P < 0.05). Social functioning and mental health scores are obviously increased but with no significant differences (P > 0.05). Prooperative MRI of 3 patients with ARCO IIC showed collapse of femoral head (< 2 mm).The collapse of 1 patients with ARCO Ⅲ A aggravated (> 4 mm). MRI of 20 hips (62.5%) showed significant improvement, while 8 hips showed no change. Conclusion Accurate preoperative localization of necrotic area, intraoperative targeted decompression and removal of dead bone followed by filling of β-TCP can effectively control the progression of femoral head necrosis, relieve hip pain,improve the function and patient satisfaction.