- Discussion: - there are some studies showing poor results following Core Decompression, however, the mainstay operation of most orthopaedic surgeons has been core decompression with cancellous bone graft;
- Markel D. et al., Clinical Orthopaedics and related Research, Number 323, pp.226-233, 1996
A retrospective review of core decompression of the femoral head for treatment of osteonecrosis
was done. The study was based on 54 hips in 45 patients. 35 hips (30 patients) were considered
to have failed.The average time to failure was 11.1 months (2-34 months). The results of core
decompression in this study were poor in general and had an unpredictable effect on disease
progression
- Fairbank A. et al., J Bone Joint Surgery,[Br] 1994, 76-B:42-49
128 femoral heads were treated with core decompression. No further surgery had been needed
for 88% of stage I, 72% of stage II, and 26% of stage III. Core decompression delays the need
for total hip replacement in young patients with AVN.
- outcome studies:
- it has been shown in two prospective studies, from Stulberg et al and
Robinson et al, that core decompression preformed in early stages,
will result in significant improvements in clinical outcomes;
- several studies have questioned the efficacy of core decompression, in later
stages of the disease;
- the addition of electrical stimulation to the core decompression does not
significantly increase the survival of the hip.
-