Core Decompression : LUSENET : About Joints : One Thread

I am 34 years old. I have a pain in my right hip for 60 days. The diagnosis is "Avascular necrosis". The Stage is (1) according to MRG but the stage is earlier than (1) according to direct radiology (X-Ray). My doctor advised core decompression. What is the rate of success for this surgery? Will I need hip replacement in future if my core decompression surgery is successful? Regards.

-- Murat Aksulu (, January 09, 2003


We cannot provide specific patient treatment information in the absence of a full consultation. However, there is a great deal of information about osteonecrosis [avascular necrosis] on our web site

-- David S. Hungerford, M.D. (, January 29, 2003.

Murat in Oct 2000 I had a core decompression done of my left hip. I also have Avascular necrosis because of steroid medication I was on for my asthma. My doctor told me that if I had it done it would put off a full hip replacement for a few years at least. It's now 1/2004 and I just had my full hip replacement done. I could have maybe gone 6 months longer to wait, but the pain was getting bad and it was limiting my time with my kids etc. I may have been able to go longer without a hip replacement but towards the end of 2003 I was put on those steroid meds again at a high dose 3 times, before that my hip had still looked good. A month later it was bad. So mine lasted 3 1/2 years almost longer before a full hip replacement, and maybe even longer if it wasn't for the steroids again. I would suggest the core decompression because it did help me. The pain wasn't completely gone, but for the first 1-2 years it was 90% better!

-- Kara Larson (, January 28, 2004.

I have stage 1+ right hip avascular necrosis with some degeneration. Both hips are bad with the left hip already in stage 3 but with no pain. I am 8 weeks post op with core decompression on the right side trying to buy myself some time because I know I will need 2 future hip replacements. Supposedly, Chemotherapy is being blamed for the condition. I have done everything the doc has asked me to do and am just beginning to put weight on the hip up to 75 lbs starting tomorrow. My leg is stiff and I am still not as comfortable as before the procedure but I am optimistic. I understand that core decompression has a 50-50 success rate in bringing back the blood supply and a little better than than in relieving pain. I cannot verify those statistics. The general consenses with me is that yes, I will need hip replacement in the future but because 2 hips are involved and only one has the option, I decided to go ahead and take the only option I had. To give the best advantage to success, I am taking 12 weeks to recover with no work and protected weight bearing. The jury is still out but I would rather keep my original parts for as long as I can. Good Luck with your decision, Abby

-- S. Abby Medivitz (, April 19, 2004.

I am 61 years old and I have osteonecrosis on the femoral head on my right leg. In February, my right leg could not support any weight at all. Had all tests done and was advised that I should be completely off the leg for 3 months. I tried for 6 weeks and then my doctor suggested core decompression with a bone graft and that it is successful in 40% of the cases. I had it done, no weight for 6 weeks, went back and the graft looked good so he said I should start physical therapy and use a cane. My surgery was April 13th and to tell the truth, the therapy hurts more than helps. I see my orthopedist July 12th. I am not optimistic as it hurts when I walk, get up. I am disappointed but I will see what he says when I go back. I do not want a hip replacement but I may have no choice. Steroids are a blessing for asthma but play havoc with your bones. Guess I needed to sound off. Thanks for listening.

-- Dolores Rosenblatt (DeeLite412, July 04, 2004.

Hi -

I had a core decompression done in 2001 on my tibia, which was also diagnosed as AVN and I was playing volleyball and it blew out my knee. I had no other symptoms. So far, 3 years and 3 weeks ago I've done okay.

I've found a great support group that I don't log onto enough but it's all about AVN and some great people and awesome information. Marie is the leader and is wonderful.

Check it out:

I also just had an MRI done on Monday for my hip. Results next Monday.

Good luck all -


-- Darlene Lundberg (, July 21, 2004.

The rate of success is very patient dependent and there are many aspects the surgeon will consider,for instance body weight, activity level, mental status,etc. Age, overall health condition and one's desire to have a full active life makes all patients similiar to you most difficult for the surgeon. He or she desires to eleviate pain and the core decompression is a first choice operation for a patient like you. This has the possibility of giving you 2 to 3 years of a more comfortable lifestyle. You may be a candidate for a total hip surgery sometime in the future and this operation is highly successful for pain and restoration of activity. There is a new technology now available called the Hemi Cap where the surgeon resurfaces the lesion and restores the roundness of the head. This appears to have great promise with regard to addressing pain and restoring full function and potentially doing so much longer than the other historically used techniques. I've been made aware of this by a 45 year old female orthopedists who has also been told they will need a total hip in a couple of years. The company behind this technology is Arthrosurface.

Good Luck

-- Karen Jones (, August 30, 2004.

Apr 2001, age 47, for no apparent reason I started to have pain in my left hip. After thinking it was nerve or muscle for about 3 weeks, I went to primary care doctor who refered me to orthopedics for review. AVN was determined. Went on crutches for time to see if taking weight off of it would correct condition. In Aug,2001 had core decompression done. After about 3 months on crutches, I went back to walking with no assistance. I had pain in my leg, more from muscles being weaken by time on crutches than anything else. I have been fine with no real problems on the left side. Last month, July 2004, my right hip started the same problem. Nothing as a real cause. Thursday 9/2, I had a decompression on my right hip. I am going through the same recovery, except I have less pain in my leg (so far) which I contribute to not being on crutches so long before the surgery (leg muscles did not weaken). In checking my right hip by MRI, we could see the left hip and its condition. My doctor was very pleased with the outcome of the left hip and its present condition. For me it worked fine and hopefully the right hip will reposnd the same.

-- Pat Bordelon (, September 04, 2004.

I am a 57 year old female who is in good health. In June of 2003 I started having hip pain when walking and standing from a sitting position. Went to primary care doctor who ordered X-ray. It showed nothing so I continued to limp for another five months when I finally went to an Orthopaedic Surgeon. He took x-rays and ordered an MRI. MRI showed osteonecrosis in my left hip but he wanted me to see a doctor who specialized in hips. After seeing the specialits in January 2004, core decompression was scheduled for February. Surgery went well, could not put weight on the hip for 6 weeks, and then followed up with physical therapy for another three months. I feel great!!! Am able to walk and move with no pain. The other hip has shown signs of bone loss but the doctor feels as long as I am not experiencing groin pain, we will leave it for now. I am very happy with the results of my surgery. I think it has a lot to do with desire to get moving again, activity levels, etc. and complete confidence in the surgeon.

-- Nancy Lanza (, October 27, 2004.

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