Recent reports show that in patients with osteonecrosis of the femoral head (ONFH), degenerative changes were already present in the acetabular cartilage, even when radiographs of the acetabulum show no abnormalities. We performed 17 hip arthroscopies to assess whether intra-articular pathological changes of ONFH are associated with the short-term results of hips treated by bipolar hip prosthesis. There were 10 female patients and 6 male patients with a mean age at the operation of 53 years (range: 20 to 82 years) and a mean follow-up of 1.9 years (range: 1.0 to 3.0 years). Eight hips were classified as stage 3A collapse of less than 3mm, 8 hips were determined to be at stage 3B collapse of 3mm or more, and one hip was categorized as stage 4 (associated with osteoarthritic changes). Following arthroscopy, 9 hips (53%) demonstrated more than mild degenerative change of the acetabulum, and 9 hips (53%) exhibited radial fibrillated labral tears. At final follow-up, no hips showed acetabular migration, component loosening, osteolysis, or increased pain. We suggest that short-term results of hips treated by bipolar hip prosthesis are not associated with intra-articular pathological changes of ONFH.