Avascular Necrosis (AVN), also known as osteonecrosis, is a painful condition that occurs when the blood supply to a bone is disrupted, leading to bone tissue death. Without proper blood flow, the bone begins to weaken and collapse, often affecting joints like the hip, knee, or shoulder. AVN progresses in stages—early symptoms may include mild joint pain, but if untreated, it can lead to severe arthritis and joint destruction.
Did You Know? AVN most commonly affects the hip joint, with over 20,000 new cases reported annually in the U.S. alone. Early diagnosis is crucial to prevent joint collapse.
Common causes of AVN include trauma (such as fractures), excessive alcohol use, long-term steroid medications, and certain medical conditions like sickle cell disease. Since bones cannot regenerate without blood supply, treatment focuses on preserving joint function. One of the most effective early-stage treatments is Core Decompression Surgery, which helps restore blood flow and prevent further damage.
Core Decompression is a minimally invasive surgical procedure designed to relieve pain and slow the progression of AVN by reducing pressure inside the bone and stimulating new blood vessel growth. The surgeon drills one or more small channels into the affected bone, which helps:
This procedure is most effective in early-stage AVN (Stage I or II), before the bone collapses. In some cases, surgeons may also inject bone graft material or stem cells into the drilled holes to enhance healing. Compared to total hip replacement (often needed in late-stage AVN), Core Decompression offers a faster recovery and preserves the patient’s natural joint.
The principle behind Core Decompression is simple yet effective: by creating small tunnels in the bone, the surgeon relieves pressure that builds up due to AVN, much like drilling a hole in a balloon to release air. This process:
Studies show that Core Decompression has a 70-90% success rate when performed in early-stage AVN. Advanced techniques, such as using bone marrow aspirate concentrate (BMAC), can further improve outcomes by introducing stem cells that aid in bone repair. Unlike joint replacement, this procedure is joint-preserving, making it ideal for younger patients who want to avoid major surgery.
Not all AVN patients are suitable for Core Decompression. The ideal candidate typically has:
Patients with late-stage AVN (Stage III or IV) may require joint replacement instead. Your orthopedic surgeon will confirm eligibility through imaging tests (X-rays, MRI) and a physical exam. Smokers or heavy alcohol users may need to modify habits before surgery to improve healing.
Core Decompression is typically an outpatient procedure, meaning patients go home the same day. Here’s what to expect:
The entire procedure takes 1-2 hours, and most patients experience immediate pain relief as pressure is released. Unlike hip replacement, there’s no need for large incisions or metal implants.
Recovery from Core Decompression varies but generally follows this timeline:
Physical therapy plays a key role in strengthening muscles and improving joint mobility. Most patients resume light work within 2 weeks, but full recovery may take 3-6 months. Follow-up imaging ensures bone healing is progressing well.
Compared to joint replacement, Core Decompression offers:
Studies report 70-90% success rates in early-stage AVN, delaying or even preventing the need for hip replacement. Combining Core Decompression with regenerative therapies (like stem cells) can further improve outcomes.
While generally safe, possible risks include:
Choosing an experienced surgeon minimizes these risks. Patients should report unusual swelling, fever, or increased pain post-op.
If Core Decompression isn’t suitable, options include:
Early intervention offers the best chance to save the joint. If you suspect AVN, consult an orthopedic specialist promptly.