Related Experiment Videos
Results of core decompression for femoral head osteonecrosis
S M Tooke1, P J Nugent, L W Bassett
1Division of Orthopaedic Surgery, UCLA School of Medicine.
Insights
Core decompression surgery shows promise for early-stage femoral head osteonecrosis (FHON). However, continued steroid use significantly increases the risk of disease progression, even after treatment.
Area of Science:
- Orthopedics
- Regenerative Medicine
- Hip Preservation Surgery
Background:
- Femoral head osteonecrosis (FHON) leads to hip joint destruction, primarily affecting young individuals.
- Nontraumatic FHON necessitates effective treatment strategies to prevent advanced joint damage.
Purpose of the Study:
- To evaluate the efficacy of core decompression in treating nontraumatic femoral head osteonecrosis (FHON).
- To assess the impact of steroid therapy on FHON progression after core decompression.
Main Methods:
- Core decompression was performed on 45 hips in 33 patients with nontraumatic FHON.
- Clinical and radiographic follow-up was conducted over a mean period of three years.
Main Results:
- No progression was observed in Ficat Stage I hips (n=10).
- Progression to coxarthrosis occurred in 11 of 26 Stage II hips and 5 of 9 Stage III hips.
- Hips with continued steroid therapy showed 50% progression versus 22% progression after discontinuation.
Conclusions:
- Core decompression is a viable treatment for Ficat Stage I and II FHON.
- Patients on continuous steroid therapy post-procedure face a substantially higher risk of FHON progression.
Abstract:
The progression of femoral head osteonecrosis (FHON) culminates in destruction of the hip joint, a devastating consequence for young people who are predominantly affected. Core decompression, as a means of ameliorating the disease, was evaluated in 45 hips in 33 patients with nontraumatic FHON. The mean clinical and roentgenographic follow-up period was three years (range, 1-7 years). None of the ten Ficat Stage I hips progressed, 11 of 26 Stage II hips progressed, and five of nine Stage III hips progressed to coxarthrosis. In those hips in which there was an association with steroid therapy, there was 50% progression when steroids were continued, compared with 22% progression when steroids had been discontinued. Core decompression is prescribed for Ficat Stage I and II. Patients on continuous post-operative treatment with steroids for associated conditions should be advised of the high risk of progression.