Core Decompression for Avascular Necrosis of the Femoral Head

Preoperative Planning and Considerations

• CT imaging is essential for surgical planning, showing the precise location and extent of the necrotic lesion 1
• The necrotic volume is a critical factor in predicting outcomes - lesions involving <30% of the femoral head have <5% progression to collapse 2, 1
• 3D-printed guide plates can improve surgical precision and decrease operative time 1

Postoperative Management

• Protected weight-bearing is recommended following the procedure to prevent fracture 1
• Regular radiographic follow-up is essential to monitor for disease progression or femoral head collapse 1

Outcomes and Considerations

• For late-stage femoral head osteonecrosis with articular collapse, more definitive procedures like hemiarthroplasty or total joint arthroplasty may be necessary, as recommended by the American College of Radiology 2