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Surgical Technique: Arthroscopic Core Decompression

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Hip Arthroscopy and Hip Joint Preservation Surgery

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Abstract

Osteonecrosis of the femoral head continues to be a challenging problem in the young patient population. Even with extensive study of this disease, the pathophysiology of this condition remains poorly understood, and often, the underlying etiology is unknown. Several risk factors have been identified, including steroid use, alcohol use, trauma, and a history of hypercoagulable and metabolic disorders. The management of osteonecrosis is dependent on the stage of the disease, which is typically divided into pre-collapse and post-collapse stages. The management of pre-collapse osteonecrosis of the femoral head is controversial, and both medical and surgical options have been described. Historical procedures included hemiresurfacing, total resurfacing, proximal femur rotational osteotomy, resection arthroplasty, and arthrodesis. The most commonly used surgical options include core decompression as well as bone grafting (vascularized or non-vascularized). Core decompression is a technique that theoretically decreases intraosseous pressure of the femoral head, resulting in a local vascularized healing response. Use of arthroscopy has recently been popularized and continues to develop into the gold standard for surgical management. Patients with advanced disease or failure of joint-preserving techniques can have excellent outcomes with total hip arthroplasty.

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Author information

Authors and Affiliations

  1. Department of Orthopaedic Surgery, University of Colorado School of Medicine, Aurora, CO, USA

    Justin K. Chang & Rachel M. Frank

  2. Department of Orthopaedic Surgery, Division of Sports Medicine, Section of Young Adult Hip Surgery, Rush University Medical Center, Chicago, IL, USA

    Rachel M. Frank

  3. Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, USA

    Anil Gupta & Michael D. Hellman

  4. Mercy Health - St. Vincent Orthopaedics and Sports Medicine, Toledo, OH, USA

    Andrew M. Kalthoff

  5. Midwest Orthopaedics at Rush, Hip Preservation Center, Rush University Medical Center, Chicago, IL, USA

    Shane J. Nho

  6. Department of Orthopaedic Surgery, Division of Sports Medicine, Section of Young Adult Hip Surgery, Rush University Medical Center, Chicago, IL, USA

    Shane J. Nho

Authors
  1. Justin K. Chang
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  2. Anil Gupta
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  3. Michael D. Hellman
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  4. Andrew M. Kalthoff
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  5. Shane J. Nho
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  6. Rachel M. Frank
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Corresponding author

Correspondence to Rachel M. Frank .

Editor information

Editors and Affiliations

  1. Department of Orthopaedic Surgery, Division of Sports Medicine, Section of Young Adult Hip Surgery, Rush University Medical Center, Chicago, IL, USA

    Shane J. Nho

  2. Sports Medicine and Shoulder Service, Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, MI, USA

    Asheesh Bedi

  3. Department of Orthopaedic Surgery, Joint Preservation and Cartilage Restoration Center, University Hospitals Case Medical Center, Cleveland, OH, USA

    Michael J. Salata

  4. Department of Orthopaedic Surgery, Duke University School of Medicine, Durham, NC, USA

    Richard C. Mather III

  5. Department of Orthopaedic Surgery, Sports Medicine and Shoulder Service, Center for Hip Preservation Surgery Weill Medical College of Cornell University, Hospital for Special Surgery, New York, NY, USA

    Bryan T. Kelly

Section Editor information

  1. Department of Orthopaedic Surgery, Henry Ford Health System and School of Medicine, Wayne State University, Detroit, MI, USA

    Eric C. Makhni

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K. Chang, J., Gupta, A., Hellman, M.D., Kalthoff, A.M., Nho, S.J., Frank, R.M. (2022). Surgical Technique: Arthroscopic Core Decompression. In: Nho, S.J., Bedi, A., Salata, M.J., Mather III, R.C., Kelly, B.T. (eds) Hip Arthroscopy and Hip Joint Preservation Surgery. Springer, Cham. https://doi.org/10.1007/978-3-030-43240-9_93

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  • DOI: https://doi.org/10.1007/978-3-030-43240-9_93

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  • Online ISBN: 978-3-030-43240-9

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