Endoscopically assisted core decompression in avascular necrosis of the femoral head.

The authors have used bone endoscopy (medulloscopy) to improve the accuracy of the conventional technique for core decompression and grafting in 36 hips with avascular necrosis of the femoral head. Endocopy was found to facilitate debridement of the necrotic bone and to decrease the risk of perforation of the cartilage during debridement. The endoscopy-assisted technique failed, however, to improve the final outcome of core decompression and grafting in more advanced stages of osteonecrosis. Based on this experience, the authors do not recommend core decompression, with or without endoscopic assistance, in advanced stages of avascular necrosis, but they suggest using endoscopic assistance during decompression in small-size lesions.