Efficacy of Core Decompression in Posttraumatic Osteonecrosis of Hip

Abstract

Core decompression is an established treatment for nontraumatic osteonecrosis of the hip. However, its efficacy in posttraumatic osteonecrosis is uncertain. Ten patients with posttraumatic osteonecrosis hip, who were operated in the authors' institute between 2005 and 2009 with core decompression, were retrospectively analyzed. Progression of the disease was defined as progression from a pre-collapse stage to stage 3, an increase in collapse, progression to stage 4, or clinical failure (performance of a subsequent operation). At every six-month follow-up, the patients were evaluated clinically (Harris Hip score [HHS]) and radiographically (MRI and radiographs of the hip) and graded according to Association Research Circulation Osseous (ARCO) staging. After a mean follow-up of 2.3 years, only two hips (20%) had radiological progression and none had the need for another surgery. The mean HHS in the preoperative period was 80 points and it was 78 at follow-up. The HHS in preoperative period was good in seven patients, fair in one, and poor in two patients. At follow-up, there were two excellent, three good, two fair, and three poor outcomes. The outcome of core decompression in posttraumatic osteonecrosis is encouraging and, although this is a small pilot study, this study supports the use of core decompression for early stage posttraumatic osteonecrosis of femoral head.