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Urinary Tract Calculi VI: Surgical Management

Procedures for Kidney StonesMedical intervention is necessary when kidney stones or renal calculi are too large to pass spontaneously (typically greater than 5 millimeters) when stones are accompanied by symptomatic infection (such as fever or pyelonephritis), when they impair kidney function, or when they cause persistent symptoms like severe pain, nausea, or urinary retention. Additionally, patients with only one kidney or those who cannot be treated with medical management also require...

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Related Experiment Video

Updated: Jul 6, 2026

Augmented Reality Navigation-Guided Core Decompression for Osteonecrosis of Femoral Head
06:17

Augmented Reality Navigation-Guided Core Decompression for Osteonecrosis of Femoral Head

Published on: April 12, 2022

Do modern techniques improve core decompression outcomes for hip osteonecrosis?

David R Marker1, Thorsten M Seyler, Slif D Ulrich

  • 1Rubin Institute of Advanced Orthopedics, Center for Joint Preservation and Reconstruction, Sinai Hospital of Baltimore, 2401 West Belvedere Avenue, Baltimore, MD 21215, USA.

Clinical Orthopaedics and Related Research
|April 9, 2008
PubMed
Summary
This summary is machine-generated.

Core decompression for osteonecrosis of the femoral head shows improved outcomes with modern techniques. Early-stage Ficat I lesions benefit most, confirming its safety and effectiveness in delaying hip replacement.

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Last Updated: Jul 6, 2026

Augmented Reality Navigation-Guided Core Decompression for Osteonecrosis of Femoral Head
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Published on: April 12, 2022

The Transition to an Anterior-Based Muscle Sparing Approach Improves Early Postoperative Function but is Associated with a Learning Curve
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Published on: September 7, 2022

Area of Science:

  • Orthopedic Surgery
  • Biomedical Engineering
  • Radiology

Background:

  • Osteonecrosis of the femoral head (ONFH) often leads to hip arthroplasty.
  • Core decompression is a surgical technique aimed at preserving the femoral head and delaying joint replacement.
  • Variability in core decompression techniques has led to inconsistent efficacy rates.

Purpose of the Study:

  • To evaluate the efficacy of modern core decompression techniques for ONFH over the past 15 years.
  • To compare recent success rates with historical data from before 1992.
  • To assess the outcomes of multiple small-diameter drillings in a patient cohort.

Main Methods:

  • Comparative analysis of radiographic and clinical success rates from recent literature and pre-1992 studies.
  • Evaluation of a cohort of 52 patients (79 hips) treated with multiple small-diameter drillings.
  • Assessment of patient selection criteria, particularly Ficat staging.

Main Results:

  • A decrease in the proportion of patients requiring additional surgeries in the recent cohort compared to pre-1992 data.
  • An increase in radiographic success rates observed in more recent reports.
  • The small-diameter drilling cohort demonstrated outcomes comparable to other recent studies, with 79% of Ficat Stage I patients showing no radiographic progression.

Conclusions:

  • Modern core decompression techniques demonstrate improved efficacy in treating ONFH compared to historical data.
  • Patient selection, particularly for early-stage (Ficat Stage I) lesions with small necrotic areas, is crucial for optimal outcomes.
  • Core decompression, especially using multiple small-diameter drillings, is a safe and effective procedure for managing early-stage femoral head osteonecrosis, potentially delaying the need for hip arthroplasty.