CLINICAL OUTCOME AND SURVIVORSHIP ANALYSIS OF CORE DECOMPRESSION FOR EARLY OSTEONECROSIS OF THE FEMORAL-HEAD

Thirty-three hips in 23 patients (followed for 5.3 years) were treated with core decompression for early osteonecrosis of the femoral head ( Ficat and Arlet I, IIA, IIB). When the clinical endpoint of severe pai n was used for survivorship, 76% of hips survived 1 year, 52% survived 2 years, and 44% survived 5 years. When the radiographic endpoint of progression to stage III disease was used, no progression was found in 72% of hips at 1 year, 61% at 2 years, and 37% at 5 years. When total hip arthroplasty was used as an endpoint, 90% of hips survived 1 year , 70% survived 2 years, and 61% survived 5 years. Lower radiographic s tage was associated with a better result. Patients who weighed less th an 79.4 kg (175 lb.) (P = .03) or whose bone stock was good (femoral i ndex < 0.56, P < .001) had significantly improved survival. Outcome ev aluation documented a 70% overall patient satisfaction rate in patient s not undergoing total hip arthroplasty.