The role of core decompression in the management of early osteonecrosis of the femoral head

Abstract

Background: Osteonecrosis represents the death of cellular elements in the marrow which progresses in stages resulting in collapse of the femoral head and its treatment is stage specific. The aim of this study was to evaluate the role of Core decompression in the management of early osteonecrosis of the femoral head. Methods: 15 patients with Stage 1 and 2 osteonecrosis of the femoral head were studied between January 2010 to January 2013 and were followed up for a period of 3 years. Results: Mean age of the patients was 36.3 years ranging from 29 to 41 years. There was a male preponderance seen in our study. Chronic alcoholism was the most common etiological factor followed by idiopathic and steroid induced. The average pre-operative Harris hip score was 52 which significantly increased to 79.8 in the post-operative period. All patients reported excellent relief of pain in the immediate post-operative period due to resolution of bone marrow edema. Follow up MRI revealed resolution of necrosis in 10 hips with progression seen in 1 hip. Conclusion: Core decompression is a safe, inexpensive procedure which gives good functional results in terms of pain relief and improvement in the quality of life for the patient if done in the early stages of Osteonecrosis before the onset of mechanical collapse of the femoral head.