Surgical treatment of osteonecrosis of the hip

Various surgical procedures are used in patients with osteonecrosis of the hip. Patients with precollapse of the femoral head are generally treated with head-preserving procedures (core decompression, various bone grafting techniques, and osteotomies), whereas those with collapse of the femoral head and/or arthritis may require arthroplasty. The arthroplasty options available include limited femoral resurfacing arthroplasty, metal-on-metal resurfacing arthroplasty, or total hip replacement. The indications, techniques, and early outcomes of some of these procedures for treatment of osteonecrosis of the hip merit discussion.