Clinical evaluation of core decompression of femoral head assisted with arthroscopy debridement for avascular necrosis of femoral head

Objective: To explore the value of multi-hole decompression of femoral head assisted with arthroscopy debridement for avascular necrosis. Methods: Forty-one cases（forty-six hips） had been treated by multi-hole decompression assisted with arthroscopy debridement from Mar, 1999 to Sep, 2003. Among them, 44 hips belonged to Ficat 0-II stage, 3 hips belonged to Ficat III stage. Core decompression of femoral head was carried out by several small diameter holes drilled by K-pin directed by fluoroscopy and arthroscopy and the hip joint was examined and debrided by hip arthroscopy.Results: According to Harris scores, average preoperative and postoperative score was 47 points and 82 points differently, postoperative Harris hip score improved significantly, the clinical successful rate was 86.9%,radiological successful1 rate was 82.6% in relation to the stage of necrosis according to the classification system of Ficat and Alert.Conclusion: This method can decrease intraosseous hypertension and improve the intraarticular environment efficiently, and can prevent the femoral head from collapsing earlier, delay the need for total hip replacement in yong patients with ischaemic necrosis. Hip arthroscopy offers a direct, minimally invasive technique to improve overall diagnostic accuracy and serves as a direct means of treatment or adjunct to application of more traditional techniques in avascular necrosis management.This method can be applied to avascular necrosis at early stage（stage 0, I, II）.