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Hip Core Decompression

Hip core decompression is a minimally invasive procedure used to treat avascular necrosis (AVN) of the thighbone (femur) in early stages of the disease by removing (coring out) diseased bone and replacing it with healthy tissue. AVN is most common in the 30s and 40s and can progress quickly, within 12 to 18 months, to complete hip joint degeneration. The goal of hip core decompression is to delay or prevent the need for a total hip replacement.

Hip osteonecrosis, also called hip AVN, is a condition that affects the head of the thighbone (femur) and results when the blood supply to the bone is interrupted. It is a progressive disorder where the lack of a blood supply leads to degeneration of bone tissue, fracture, and collapse of the bone. Without treatment, AVN can lead to hip joint degeneration necessitating hip replacement.

Hip osteonecrosis is a condition with a wide variety of causes including trauma, steroid use, and chronic alcohol consumption. The most common cause is trauma that disrupts blood flow to the bone. Steroid use is the second most common cause of hip osteonecrosis.

Traumatic osteonecrosis of the hip is typically unilateral, affecting just the hip that suffered the trauma. Atraumatic osteonecrosis affects both leg bones because it is caused by systemic diseases such alcohol consumption, steroid use, immunotherapy medications, and diseases that impair blood flow like sickle cell anemia or lupus.

Osteonecrosis is commonly seen in the hip, but it can also occur in other joints such as the shoulder or knee. Symptoms include acute or chronic pain with weight bearing or joint movement. Severe cases can lead to joint deformity and disability. There is no cure, but treatment can slow or halt progression and relieve symptoms.

Diagnosis and staging are based on X-Ray and MRI imaging at any stage. Initial evaluation includes a history and focussed physical examination.

Hip core decompression is a minimally invasive hip joint preserving procedure. It involves surgical removal of diseased bone to relieve pressure and slow or stop further bone destruction. Coring out the diseased bone stimulates the presence of vascular receptors in the bone, which facilitates growth of new blood vessels thereby promoting repair and regrowth of bone in head of femur.

The experts at LALL Orthopedics+ enhance the effect bone regrowth following core decompression by using cutting-edge regenerative medicine techniques such as Stem-Cell Therapy and Platelet-Rich Plasma (PRP) to promote faster and stronger regrowth of bone tissue. Core decompression is most commonly performed as an outpatient same-day procedure.

Studies have shown improvement in patients treated with core decompression and delayed time to total hip replacement. When treated at the earliest stage, core decompression leads to higher hip survival rates and improved quality of life in affected patients.

Dr. Ajay C. Lall is a triple fellowship trained orthopedic surgeon, sports medicine doctor and expert in hip preserving techniques like core decompression and hip arthroscopy. When you have hip pain as a result of trauma, or have systemic diseases that can interfere with blood supply, it is essential to get the right diagnosis and treatment to prevent osteonecrosis and joint collapse. Contact Dr. Lall at LALL Orthopedics+ to schedule a consultation.

Dr. Ajay C. Lall is a former dual sport NCAA collegiate athlete (football and track & field), American board certified, triple fellowship-trained expert orthopedic surgeon who specializes in hip arthroscopy and robotic hip replacement. He treats non-athletes and athletes at all levels of play from collegiate to professional to the Olympic level. Dr. Lall is a world-renowned orthopedic surgeon who cares for all patients like family. Contact LALL Orthopedics + to schedule a consultation, receive the correct diagnosis, and undergo state-of-the-art treatment options.

At a Glance

Ajay C. Lall, MD, MS, FAAOS

  • Board Certified – Orthopedic Surgery
  • Triple Fellowship Trained
  • Performs over 750 Surgeries Per Year
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