Core decompression for the treatment of avascular necrosis of the femoral head

David S. Hungerford

Research output: Contribution to journalArticle

Abstract

Core decompression for the treatment of avascular necrosis of the femoral head was introduced by Ficat and Arlet in 1962 with results first reported in 1968. Since 1973 the author has used the technique with good results in the precollapse stage and a low complication rate. The recent literature has reported varied results. Bone functions as a closed compartment (as a Starling resistor). Markedly elevated bone marrow pressures have been recorded in all stages of avascular necrosis of the femoral head, making core decompression a rational procedure. However, to avoid the pitfalls, the following precautions must be exercised: (a) biplane image intensification avoids articular perforation; (b) clearance of the coring device avoids femoral head blow-out; and (c) metaphyseal rather than diaphyseal entry site dramatically lowers the incidence of secondary fracture. Core decompression in the author's experience provides an effective procedure with low morbidity in the precollapse stages of the disease.

Original languageEnglish (US)
Pages (from-to)182-188
Number of pages7
JournalSeminars in Arthroplasty
Volume2
Issue number3
StatePublished - 1991

Fingerprint

Femur Head Necrosis
Decompression
Starlings
Thigh
Therapeutics
Joints
Bone Marrow
Morbidity
Pressure
Bone and Bones
Equipment and Supplies
Incidence

ASJC Scopus subject areas

  • Surgery

Cite this

Core decompression for the treatment of avascular necrosis of the femoral head. / Hungerford, David S.

In: Seminars in Arthroplasty, Vol. 2, No. 3, 1991, p. 182-188.

Research output: Contribution to journalArticle

@article{91223ebcf8aa49b09d80bf9492985f38,
title = "Core decompression for the treatment of avascular necrosis of the femoral head",
abstract = "Core decompression for the treatment of avascular necrosis of the femoral head was introduced by Ficat and Arlet in 1962 with results first reported in 1968. Since 1973 the author has used the technique with good results in the precollapse stage and a low complication rate. The recent literature has reported varied results. Bone functions as a closed compartment (as a Starling resistor). Markedly elevated bone marrow pressures have been recorded in all stages of avascular necrosis of the femoral head, making core decompression a rational procedure. However, to avoid the pitfalls, the following precautions must be exercised: (a) biplane image intensification avoids articular perforation; (b) clearance of the coring device avoids femoral head blow-out; and (c) metaphyseal rather than diaphyseal entry site dramatically lowers the incidence of secondary fracture. Core decompression in the author's experience provides an effective procedure with low morbidity in the precollapse stages of the disease.",
author = "Hungerford, {David S.}",
year = "1991",
language = "English (US)",
volume = "2",
pages = "182--188",
journal = "Seminars in Arthroplasty",
issn = "1045-4527",
publisher = "W.B. Saunders Ltd",
number = "3",

}

TY - JOUR

T1 - Core decompression for the treatment of avascular necrosis of the femoral head

AU - Hungerford, David S.

PY - 1991

Y1 - 1991

N2 - Core decompression for the treatment of avascular necrosis of the femoral head was introduced by Ficat and Arlet in 1962 with results first reported in 1968. Since 1973 the author has used the technique with good results in the precollapse stage and a low complication rate. The recent literature has reported varied results. Bone functions as a closed compartment (as a Starling resistor). Markedly elevated bone marrow pressures have been recorded in all stages of avascular necrosis of the femoral head, making core decompression a rational procedure. However, to avoid the pitfalls, the following precautions must be exercised: (a) biplane image intensification avoids articular perforation; (b) clearance of the coring device avoids femoral head blow-out; and (c) metaphyseal rather than diaphyseal entry site dramatically lowers the incidence of secondary fracture. Core decompression in the author's experience provides an effective procedure with low morbidity in the precollapse stages of the disease.

AB - Core decompression for the treatment of avascular necrosis of the femoral head was introduced by Ficat and Arlet in 1962 with results first reported in 1968. Since 1973 the author has used the technique with good results in the precollapse stage and a low complication rate. The recent literature has reported varied results. Bone functions as a closed compartment (as a Starling resistor). Markedly elevated bone marrow pressures have been recorded in all stages of avascular necrosis of the femoral head, making core decompression a rational procedure. However, to avoid the pitfalls, the following precautions must be exercised: (a) biplane image intensification avoids articular perforation; (b) clearance of the coring device avoids femoral head blow-out; and (c) metaphyseal rather than diaphyseal entry site dramatically lowers the incidence of secondary fracture. Core decompression in the author's experience provides an effective procedure with low morbidity in the precollapse stages of the disease.

UR - http://www.scopus.com/inward/record.url?scp=12644313783&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=12644313783&partnerID=8YFLogxK

M3 - Article

AN - SCOPUS:12644313783

VL - 2

SP - 182

EP - 188

JO - Seminars in Arthroplasty

JF - Seminars in Arthroplasty

SN - 1045-4527

IS - 3

ER -