Arthroscopy-Assisted Core Decompression and Bone Grafting for Avascular Necrosis of the Hip

Although specific techniques vary, core decompression is generally accepted as the treatment of choice for precollapse avascular necrosis (AVN) of the hip to delay or prevent progression of the disease. This can be combined with hip arthroscopy to allow visual assessment of the femoral head as well as treatment of intra-articular pathologies, which may contribute to pain and joint degeneration. We describe a technique of hip arthroscopy and concurrent core decompression using an expandable reamer and bone grafting for treatment of hip AVN. This allows for minimally invasive treatment of both bony and intra-articular soft tissue pathologies, which are often concomitantly present in hip AVN disease, while minimizing reaming of healthy femoral bone.