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)
Cost depends on your health fund, level of cover, hospital, and individual circumstances. Eligible patients may be able to access a no-gap pathway for primary joint replacement — see our Private Health Cover page for details, or book a consultation for a personalised estimate.
DAIR (Debridement, Antibiotics and Implant Retention) is a procedure used to treat infection in a hip or knee replacement while preserving the original implant. It’s suitable when infection is caught early, typically within about 4 weeks of the original surgery, or within 3 weeks of symptoms starting in a previously well-functioning joint — provided the implant is stable and well-fixed, with no signs of loosening.
Hip resurfacing is an alternative to conventional total hip replacement in which the femoral head is reshaped and capped with a prosthesis rather than removed. The acetabulum is resurfaced with a separate cup that articulates with the femoral cap. Because the femoral head and neck are preserved, resurfacing maintains the natural biomechanics of the hip, conserves bone stock for any future revision, and can allow a remarkable return to high-impact activities in selected patients.
Traditional metal-on-metal hip resurfacing was introduced in the 1990s and gained widespread popularity in young, active patients because of its excellent functional results. However, concerns about metal ion release, adverse local tissue reactions (pseudotumours) and higher revision rates, particularly in women and patients with smaller femoral heads, led to a significant decline in its use.
ReCerf is a modern ceramic-on-ceramic hip resurfacing implant, developed specifically to address the limitations of metal-on-metal resurfacing while preserving the functional advantages of the resurfacing concept. It uses a fourth-generation alumina-matrix composite ceramic (BIOLOX® delta) for both the femoral cap and the acetabular cup, eliminating metal ions from the bearing surfaces.
ReCerf is one of the most significant advances in hip resurfacing and represents a true evolution of the procedure.
Piriformis syndrome is an uncommon cause of buttock and posterior thigh pain, caused by irritation or compression of the sciatic nerve by the piriformis muscle. Surgical release of the piriformis and decompression of the sciatic nerve is reserved for the small group of patients with severe, disabling symptoms that have failed prolonged non-operative treatment, and in whom other causes of sciatic nerve pain have been excluded.
Cost depends on your health fund, level of cover, hospital, and individual circumstances. Eligible patients may be able to access a no-gap pathway for primary joint replacement — see our Private Health Cover page for details, or book a consultation for a personalised estimate.
Typically 1-2 hours for a standard primary hip replacement, though total time in the operating room (including anaesthesia setup and positioning) often runs a bit longer than that. Patients are usually in theatre for around 2–3 hours in total. Robotic-assisted and complex revision cases can take longer due to additional imaging-based planning and precision steps during the procedure.
The direct anterior approach is a muscle-sparing technique for hip replacement, where the surgeon accesses the hip joint through a natural interval between muscles rather than cutting through them. It’s one of several surgical approaches Dr Stoita uses, selected based on individual anatomy and clinical suitability. Dr Stoita will discuss which approach is right for you at consultation.
A significant cause of hip pain in women over 50 is greater trochanteric pain syndrome, often related to tears of the gluteus medius and minimus tendons, sometimes called the “rotator cuff of the hip.” These tendons are critical for hip stability during walking. When 6–12 months of physiotherapy, activity modification and injections don’t resolve symptoms, surgical repair can provide durable pain relief.
Please note, all surgical procedures carry risks. Please book an appointment with Dr Stoita to find out what the best treatment option is for you.
Robotic-assisted surgery is an important advancement in modern joint replacement. Combined with the concept of functional alignment, it allows the procedure to be tailored to each patient’s individual anatomy rather than following a one-size-fits-all approach. Dr Stoita routinely uses computerised and robotic surgical techniques for hip and knee replacement, and was NSW’s first surgeon to perform robotic total knee replacement using the NAVIO system’s 3D mapping technology.
For eligible patients, Dr Stoita offers a no-gap pathway for primary hip and knee joint replacement, and for select revision cases. Eligibility depends on your health fund, your level of cover, and the hospital where your surgery takes place.
Next Steps
1. Contact your health insurer to check your eligibility for hip/knee replacement, including level of coverage and waiting periods the hospital excess applicable to your health insurance.
2. Make an appointment with your GP to request a referral to Dr Razvan Stoita.
3. Book an appointment with Dr Razvan Stoita.
Please note:consultation fees are not included in the ‘No-Gap’ Joint Replacement Program.
