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Updated: Mar 12, 2026
Augmented Reality Navigation-Guided Core Decompression for Osteonecrosis of Femoral Head
Published on: April 12, 2022
Core Decompression for Osteonecrosis of the Femoral Head in Pediatric Hematologic Malignancy Survivors: A Systematic
Emily K Krisanda1, Carol D Morris2, Adam S Levin2
1Georgetown University School of Medicine, Washington, DC.
Insights
Core decompression (CD) for pediatric osteonecrosis of the femoral head (ONFH) in cancer survivors shows limited evidence. Many patients still required total hip arthroplasty (THA) after CD, with no clear reduction in joint collapse risk.
Area of Science:
- Orthopedic Surgery
- Pediatric Oncology
- Hematology
Background:
- Children with leukemia or lymphoma have increased risk of osteonecrosis of the femoral head (ONFH).
- Core decompression (CD) is a surgical option for ONFH to potentially delay or avoid total hip arthroplasty (THA).
Conclusions:
- Limited evidence exists regarding the efficacy of CD for ONFH in pediatric patients with a history of hematologic malignancy.
- Further research is needed to establish clear guidelines for the use of CD in this specific patient population.
Abstract:
Children treated for leukemia or lymphoma are predisposed to a higher incidence of osteonecrosis at a young age. Core decompression (CD) is performed for treatment of osteonecrosis of the femoral head (ONFH) to delay or prevent subchondral collapse and subsequent total hip arthroplasty (THA). The goal of the present systematic review was to determine outcomes of CD in pediatric patients with a history of hematologic malignancy who developed ONFH. Of 4,424 studies screened by title, abstract, and full text, 4 retrospective studies were included. Of 253 hips with ONFH, CD was performed in 78 (30.8%). Conversion to THA occurred in 46.2% of patients an average of 20.3 months after CD. None of the studies reported a significant difference in risk of joint collapse following CD. There is limited evidence for or against the use of CD in the treatment of ONFH for pediatric patients with a history of hematologic malignancy. Level of Evidence: Level III, Diagnostic study. (Journal of Surgical Orthopaedic Advances 35(1):010-013, 2026).
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