Core decompression ("conventional method") in atraumatic osteonecrosis of the hip.

[Core decompression ("conventional method") in atraumatic osteonecrosis of the hip]. Oper Orthop Traumatol. 2019 Nov 21;: Authors: Benignus C, Lüring C, Beckmann J Abstract OBJECTIVE: Retrograde drilling of a necrotic zone within the femoral head to reduce intraosseous pressure and stimulate revascularization. INDICATIONS: Atraumatic osteonecrosis of the hip ARCO stage I (reversible) and ARCO stage II (potentially reversible) with a medial or central necrotic zone  30%, infections. SURGICAL TECHNIQUE: Supine position. Visualization of the necrotic zone via an image intensifier, approach is determined by using a Kirschner wire, laterodorsal skin incision on a level with the wire, longitudinal incision of iliotibial band and vastus lateralis muscle, drilling the necrotic zone with a 2-3 mm Kirschner wire, optionally placing more wires or a hollow drill, wound closure. POSTOPERATIVE MANAGEMENT: Partial weightbearing with 20 kg for 6 weeks due to risk of fracture, followed by avoidance of jumping or sprinting for another 6 weeks; physiotherapy from day 1 after surgery, thromboembolic prophylaxis until full weightbearing is possible. RESULTS: Results are dependent on ARCO stages and are promising in early stages. PMID: 31754745 [PubMed - as supplied by publisher]
Source: Operative Orthopadie und Traumatologie - Category: Orthopaedics Authors: Tags: Oper Orthop Traumatol Source Type: research

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