Techniques of core decompression in the treatment of idiopathic avascular necrosis of the femoral head.

Autor: Dubé MD; Department of Orthopaedic Surgery, Cleveland Clinic, Cleveland, OH, USA., Emara AK; Department of Orthopaedic Surgery, Cleveland Clinic, Cleveland, OH, USA., Deren ME; Department of Orthopaedic Surgery, Cleveland Clinic, Cleveland, OH, USA., Pasqualini I; Department of Orthopaedic Surgery, Cleveland Clinic, Cleveland, OH, USA., Rullan PJ; Department of Orthopaedic Surgery, Cleveland Clinic, Cleveland, OH, USA., Tidd J; Department of Orthopaedic Surgery, Cleveland Clinic, Cleveland, OH, USA., Piuzzi NS; Department of Orthopaedic Surgery, Cleveland Clinic, Cleveland, OH, USA. piuzzin@ccf.org.; Department of Biomedical Engineering, Cleveland Clinic, Cleveland, OH, 44195, USA. piuzzin@ccf.org.; Department of Orthopaedic Surgery, Cleveland Clinic, 9500 Euclid Ave, Suite A40, Cleveland, OH, 44195, USA. piuzzin@ccf.org.
Jazyk: angličtina
Zdroj: Archives of orthopaedic and trauma surgery [Arch Orthop Trauma Surg] 2024 Dec 21; Vol. 145 (1), pp. 82. Date of Electronic Publication: 2024 Dec 21.
DOI: 10.1007/s00402-024-05732-5
Abstrakt: Core decompression was developed as a joint-preserving procedure for patients with early-stage osteonecrosis of the femoral head. Previous studies indicated a high success rate that outperforms nonoperative management of pre-collapse hips. The traditional single-tunnel core decompression technique uses a cannulated drill bit inserted into the lateral cortex of the proximal femur. Multiple small drilling was introduced to decrease the risk of fracture through a less invasive technique. Adjunctive therapeutics such as tantalum rods, bone-grafting, orthobiologic (e,g, bone marrow aspirate concentrate, mesenchymal stem cells, platelet-rich plasma, and human umbilical cord mesenchymal stem cell extracts) as well as electric stimulation have all been studied. No consensus regarding the ideal treatment has been reached. This review analyzes the advantages and disadvantages of current core decompression techniques to provide orthopaedic surgeons with direction in managing patients with avascular necrosis of the femoral head.
Competing Interests: Declarations. Competing interests: All other authors have no disclosures.
(© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)
Databáze: MEDLINE
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