Hip Osteonecrosis


Osteonecrosis is a medical condition that occurs when the blood supply to the spongy bone next to a joint is reduced, causing the bone to stop its biological activity. This loss of activity weakens the bone and can cause it to collapse over time due to the compressive forces acting on the joint. Eventually, this can lead to a degenerative joint disease that may require prosthetic joint replacement surgery.

Osteonecrosis is commonly associated with steroid medication use and usually affects the hip joint in younger adults. However, joint replacement surgery is often not desirable for younger patients with stage I or II hip osteonecrosis because it is a no-return surgery. In such cases, hip-preserving surgery options are recommended as they can help patients avoid degenerative joint disease and eliminate the need for joint replacement surgery.

kalça koruyucu 3D yardımlı cerrahi

When considering hip-preserving surgery, it is important to take into account the volume of necrotic tissue in the femoral head and its relation to the weight-bearing parts of the joint. This information can help determine if hip-preserving surgery will be beneficial for the patient.

The principle of core decompression for osteonecrosis of the hip involves drilling a tunnel from the lateral surface of the femur to the head of the femur. The necrotic bone mass is then evacuated and the reamed borehole is filled with bone grafts. Traditionally, this procedure is guided by a radioscopy device, essentially an X-ray with a screen in the operating room. However, osteonecrosis is generally not easily visible on X-rays as a result this can lead to poor drill hole placement and poor outcomes. 

We plan the ideal drilling path and depth for every patient in a 3D virtual computer environment. From the plan, we derive a 3D-printed patient-specific drilling guide which is used during the surgery to guarantee the best possible necrosis targeting and evacuation of dead bone.  Further stem cell-enriched bone grafting through the drilled hole supports the overlying cartilage against collapse and provides desirable conditions for the necrotic bone to regenerate. 

Thorough 3D virtual planning and precise patient-specific drilling can improve the likelihood of patients maintaining a life free from progressing to degenerative joint disease, potentially avoiding the necessity for joint replacement surgery.

Please contact us to find out if your condition of osteonecrosis is suitable to be given a chance for "patient-specific core-decompression" 

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