Core Decompression of the Femoral Head
What is Core Decompression of the Femoral Head?
Core decompression is a joint-preserving procedure used in the early stages of avascular necrosis (AVN) of the femoral head, before collapse of the femoral head has occurred. The aim of the procedure is to reduce the intra-osseous pressure within the femoral head, relieve pain and stimulate biological healing of the affected bone, potentially preventing progression to collapse and the subsequent need for hip replacement.
The success of core decompression is highly dependent on early diagnosis. The procedure is most effective when performed in the earliest stages of AVN, before any structural collapse of the femoral head. Once the femoral head has collapsed or secondary osteoarthritis has developed, core decompression is no longer appropriate and hip replacement becomes the treatment of choice.
Who is suitable?
Core decompression is indicated for:
Dr Stoita will review your symptoms, activity goals, and any existing imaging. A detailed clinical examination is performed to confirm the diagnosis and discuss whether this procedure is the right option for you.
Initial visitX-rays, MRI or other imaging may be used to confirm the diagnosis and assess the extent of the condition. In complex cases, 3D computerised modelling may be used to assist with surgical planning.
Pre-surgeryThe procedure is performed under anaesthesia using the most appropriate surgical technique for your condition. Dr Stoita uses minimally invasive approaches where possible to reduce recovery time and optimise outcomes.
Day of procedureMost patients are discharged home the same day or the following morning.
Partial weight bearing with crutches is required to offload the femoral head and reduce the risk of subchondral fracture during early healing.
Progression to full weight bearing, with increasing range of motion and strengthening exercises.
Return to full activities of daily living, low-impact exercise and a gradual return to higher-level activity.
Frequently Asked Questions (FAQ)
Hip arthritis usually develops over time rather than from a single cause. The most common reason is gradual wear of the joint cartilage with age. However, many people develop it earlier due to subtle issues with the shape of the hip, when the ball and socket don’t fit perfectly, it creates uneven pressure that slowly damages the joint. Previous injuries, such as fractures or dislocations, can also speed up this process. In some cases, genetics, inflammation, or increased load on the joint (including higher body weight or repetitive stress) contribute.
In a total knee replacement, the entire knee joint surface is replaced – the ends of the femur (thigh bone), tibia (shin bone), and usually the underside of the kneecap are all resurfaced with artificial components. In a partial knee replacement (PKR), also called unicompartmental knee replacement, only the damaged compartment of the knee is replaced, leaving healthy bone, cartilage, and ligaments intact.
Diagnosis involves understanding a history of your symptoms, examining your knee, and using imaging such as X-rays to assess cartilage wear and joint alignment. In some cases, additional scans such as CT or MRI scans may be required to either exclude other conditions or quantify the degree of arthritis.Some patients develop patellofemoral pain syndrome in the absence of any bone, joint or soft tissue abnormalities. However, most patients with the syndrome present with one or more abnormalities related to bone anatomy, joint anatomy and/or soft tissue.
Although knee arthritis can affect anyone, there are several factors that can increase the risk of arthritis:
- Genetic predisposition
- Previous knee injury or surgery
- Other joint conditions such as rheumatoid arthritis or gout
- Occupations involving heavy manual work
- Age (over 40)
- Female gender
- Being overweight or obese
- Participation in high impact activities or sports (e.g. running, soccer or rugby)
Knee arthritis typically develops as a result of progressive cartilage wear within the joint. This process may occur naturally with age or be accelerated by factors such as previous injury, altered joint alignment, or increased mechanical load.
In some cases, inflammatory conditions such as rheumatoid arthritis can also contribute to joint degeneration.
