Osseoscopy: Direct Visualization to Assist Core Decompression and Debridement of Necrotic Bone Defects

Free vascularized fibular grafting after core decompression and debridement of necrotic lesions is an effective surgical treatment of avascular necrosis of the femoral head. A technical challenge encountered in performing this procedure is ensuring adequate debridement of necrotic parts while preserving healthy bone. A previously described method accomplishes this indirectly using radioactive contrast media and fluoroscopy, increasing the risk of radiation exposure. We propose a surgical technique using standard arthroscopic equipment to visualize inside the femoral head, facilitating precise and accurate debridement without additional radiation exposure.