Core Decompression

Core decompression is a minimally invasive surgical procedure that is useful in treating the precollapse stages of osteonecrosis. Numerous publications have shown that the procedure relieves symptoms and delays progression of the precollapse lesions in up to 80% of the cases followed for greater than 10 years. Results are better in smaller lesions. The procedure is usually not indicated once the femoral head has started to structurally fail. Compared with other "preservative" procedures including osteotomies and free vascularized fibular bone grafts, core decompression does not compromise any subsequent procedures that might become necessary. Although the procedure is straightforward, attention to the details which are presented is necessary to avoid potential complications including subtrochanteric fracture, femoral head blow out, and femoral head perforation.