CORE DECOMPRESSION FOR EARLY OSTEONECROSIS OF THE HIP IN HIGH-RISK PATIENTS

Thirty-four hips (22 patients) with history and physical findings cons istent with osteonecrosis of the femoral head were evaluated preoperat ively by radiographs, bone scans and magnetic resonance images, All pa tients with Stage 0, I, or II disease by the Ficat and Arlet classific ation underwent core decompression using the same technique, Osteonecr osis was confirmed histologically in all 34 hips, Eighteen of 22 patie nts had prognostic factors traditionally associated with poor outcome including collagen vascular diseases and continued use of steroids, Fo llowup averaged 4 years for 18 patients with 29 hips, Four patients di ed secondary to systemic illness, Twelve patients had good or excellen t results using the Modified Harris Hip Score with 6 patients needing hip arthroplasty, In this group of patients previously associated with poor prognosis, no hip fractures were seen and 66% good to excellent results were obtained.