Core decompression of the femoral head. Literature review

Abstract

Avascular necrosis (AVN) of the femoral head is a disease, characterized by the death of osteocytes and bone marrow, leading to collapse of the femoral head and dysfunction of the hip joint. There are many known risk factors for the development of this disease including trauma of the hip joint, hemoglobinopathy, alcoholism, taking corticosteroids, collagenosis, etc. Conservative treatment (drug therapy using vascular drugs, bisphosphonates, chondroprotectors, NSAIDs, physiotherapy, exercise therapy) is shown for any stage of the hip AVN, however, surgical treatment has a higher potential. The key to successful treatment is the detection of AVN at an early (pre-collapse) stage to prevent subsequent collapse by performing organ-sparing surgical interventions that reduce the rate of disease progression and allow delaying of the hip replacement. The literature describes a number of organ-preserving operations performed at an early stage of AVN. Currently, there are three main areas of surgical treatment of this disease: classical decompression of the femoral head, decompression using various types of grafts and combined treatment using various cellular technologies. This literature review is devoted to the consideration of the indications for implementation, as well as the results of treatment of patients using the above techniques.