Evaluation of core decompression for early osteonecrosis of the femoral head.

Abstract

Twenty-six hips (19 patients) with osteonecrosis of the femoral head with stage I or II of the disease, according to the Ficat and Arlet classification, underwent core decompression. Osteonecrosis was confirmed histologically in all 26 hips. Of 19 patients, 7 had prognostic factors traditionally associated with poor outcome including collagen vascular disease and continued use of steroids. The follow-up period averaged 7 years 10 months (range: 2 years 5 months-13 years 8 months) for 17 patients with 24 hips. Two patients died secondary to systemic illness. Seventeen hips (65.4%) had very good or good results using the Ficat criteria. Eight hips (30.8%) needed further operation [total hip arthroplasty (THA) for 7 hips, osteotomy for 1 hip]. Of the 12 hips in patients who had used steroids, 6 hips (50%) were converted to THA. Four hips in patients with systemic lupus erythematosus (SLE) needed THA (100%). We conclude that core decompression provides an effective treatment for steroid-associated osteonecrosis other than in cases with SLE, as well as providing effective treatment for non-steroid-associated osteonecrosis in the early stages of the disease.

• Authors: S Maniwa, T Nishikori, S Furukawa, K Kajitani, A Iwata, U Nishikawa, M Ochi
• Journal: Archives of orthopaedic and trauma surgery (Arch Orthop Trauma Surg) Vol. 120 Issue 5-6 Pg. 241-4 ( 2000) ISSN: 0936-8051 [Print] Germany
• PMID: 10853887 (Publication Type: Journal Article)

Topics

• Adult
• Aged
• Arthroplasty, Replacement, Hip
• Decompression, Surgical
• Female
• Femur Head Necrosis (diagnosis, etiology, surgery)
• Follow-Up Studies
• Humans
• Male
• Middle Aged
• Postoperative Complications (diagnosis, surgery)
• Reoperation
• Treatment Outcome