Surgical Technique: Core Decompression of Femoral Head Osteonecrosis with Bone Marrow Aspirate Concentrate

Osteonecrosis of the femoral head is a progressive and potentially debilitating disorder that is responsive to core decompression, especially in early-stage disease. This is typically accomplished through use of an 8 to 10mm trephine or multiple, small-diameter percutaneous drilling. Use of the large diameter trephine is associated with risk of fracture and may not allow healing across large gaps. Here, we present a technique for core decompression using percutaneous drilling that allows bone marrow aspiration concentrate to be introduced. We used the aspirate needle to decompress the femoral head osteonecrotic lesion, followed by the administration of bone marrow aspirate concentrate. This is a straightforward procedure that can be used with low risk for patient morbidity.