Core decompression in the treatment of necrosis of the femoral head. Long-term results.

Long-term follow-up (5 years and 7 months) was obtained for the results of core decompression in 18 patients (20 hips) affected with ischemic necrosis of the femoral head at Ficat stages I and IIA. Two methods were used to diagnose osteonecrosis: bone scan, and MRI. Progression of the disease was monitored by annual MRI. The persistence of pain, progression of the disease in the Ficat scale, the use of total arthroplasty, were considered to be signs of failure. Core decompression was favorable in 16 hips, there was progression of the disease in 4. Good results were observed in 90% of the stage I necroses and in 70 of the stage IIA necroses. The results of the present study suggest bone reaming as the treatment of choice in initial stages of necrosis. Thus, the need for arthroplasty in young patients is delayed.