CORE DECOMPRESSION FOR OSTEONECROSIS OF THE FEMORAL-HEAD

A retrospective review of core decompression of the femoral head for t reatment of osteonecrosis was done. Cause of osteonecrosis, radiograph ic stage and progression, complications, and clinical results were eva luated. The study was based on 54 hips in 45 patients (98.2% followup rate), All patients reported pain preoperatively. Thirty-five hips (30 patients) were considered to have failed. Of these, 26 hips (23 patie nts) underwent total hip arthroplasty, The remaining 9 hips (7 patient s) had little or no relief of pain and no improvement in function, but had not undergone total hip arthroplasty at last followup. The averag e time to failure was 11.1 months (2-34 months). Nineteen hips (16 pat ients) were considered successful. Fifteen hips (12 patients) were gra ded good to excellent and 4 hips (4 patients) were graded fair in term s of clinical results with an average followup of 47.5 months (12.4-95 .7 months). The mean preoperative Hospital for Special Surgery hip sco re improved from 24.6 points (range, 18-38 points) to 34.2 points (ran ge, 20-40 points). There were 2 intertrochanteric femur fractures in t his group (5 and 6 weeks postoperatively). The overall success rate of core decompression in this series was 35.2% (19 of 54 hips, 45 patien ts). The results of core decompression in this study were poor in gene ral and had an unpredictable effect on disease progression.