title: Clinical outcome and survivorship analysis of core decompression for early osteonecrosis of the femoral head.
abstract: Thirty-three hips in 23 patients (followed for 5.3 years) were treated with core decompression for early osteonecrosis of the femoral head (Ficat and Arlet I, IIA, IIB). When the clinical endpoint of severe pain was used for survivorship, 76% of hips survived 1 year, 52% survived 2 years, and 44% survived 5 years. When the radiographic endpoint of progression to stage III disease was used, no progression was found in 72% of hips at 1 year, 61% at 2 years, and 37% at 5 years. When total hip arthroplasty was used as an endpoint, 90% of hips survived 1 year, 70% survived 2 years, and 61% survived 5 years. Lower radiographic stage was associated with a better result. Patients who weighed less than 79.4 kg (175 lb.) (P = .03) or whose bone stock was good (femoral index < 0.56, P < .001) had significantly improved survival. Outcome evaluation documented a 70% overall patient satisfaction rate in patients not undergoing total hip arthroplasty.
authors.affiliation: Department of Orthopaedic Surgery, Lahey Hitchcock Medical Center, Burlington, Massachusetts 01805, USA.
authors.forename: R
authors.initials: R
authors.lastname: Iorio
authors.forename: W L
authors.initials: WL
authors.lastname: Healy
authors.forename: A J
authors.initials: AJ
authors.lastname: Abramowitz
authors.forename: B A
authors.initials: BA
authors.lastname: Pfeifer
mesh_terms: D000293:Adolescent; D000328:Adult; D019644:Arthroplasty, Replacement, Hip; D019299:Decompression, Surgical / Q000009:adverse effects / Q000379:methods; D018450:Disease Progression; D005260:Female; D005271:Femur Head Necrosis / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000601:surgery; D011859:Radiography; D012086:Reoperation; D012189:Retrospective Studies; D012307:Risk Factors; D011795:Surveys and Questionnaires; D016896:Treatment Outcome