J Korean Hip Soc.  2009 Sep;21(3):219-225. 10.5371/jkhs.2009.21.3.219.

The Efficacy of Core Decompression for Treating Avascular Necrosis of the Femoral Head

• Shim KB
• Kwon DS
• Oh SJ
• Kang JS
• Moon KH

• KMID: 1465825
• DOI: http://doi.org/10.5371/jkhs.2009.21.3.219

Abstract

PURPOSE
We evaluated the efficacy of core decompression (CD) for treating early avascular necrosis of the femoral head (ANFH), as well as the effect of an autogeneous bone graft and an DBM graft on the results of CD.
MATERIALS AND METHODS
This study included 37 patients (40 cases) who were initially diagnosed as suffering with early ANFH, and they were treated with CD and followed up for a minimum of two years. The average patient age was 47.8 years and the average follow up period was 62.4 months., The Ficat & Arlet (F&A) stage and the ARCO stage were used for the radiological staging.
RESULTS
The failure rate was 65% (26 case), and 32.5% (13 cases) underwent THA due to clinical and radiological failure. According to the F&A stage, there were 10 stage I hips, 22 stage IIA hips and 8 stage IIB hips, and the success rate (SR) of core decompression was 60%, 36.4% and 0%, respectively. The differences were statistically significant. The cases of ARCO stage II were divided into subgroups: A 2 hips, B 13 hips and C 12 hips and the SR of each were 50%, 46%, and 33.3%, respectively. The differences were statistically significant.
CONCLUSION
CD should be carefully considered for treating the advanced stages above F&A stage IIA and ARCO stage IIB.

Keyword

Avascular necrosis of the femur head; Core decompression

MeSH Terms

Artemisinins
Decompression
Follow-Up Studies
Head
Hip
Humans
Naphthoquinones
Necrosis
Stress, Psychological
Tacrine
Transplants
Artemisinins
Naphthoquinones
Tacrine