Surgical Technique: Core Decompression of Femoral Head Osteonecrosis with Bone Marrow Aspirate Concentrate

Abstract

Osteonecrosis of the femoral head is a progressive and potentially debilitating disorder that is responsive to core decompression, especially in early-stage disease. This is typically accomplished through use of an 8 to 10mm trephine or multiple, small-diameter percutaneous drilling. Use of the large diameter trephine is associated with risk of fracture and may not allow healing across large gaps. Here, we present a technique for core decompression using percutaneous drilling that allows bone marrow aspiration concentrate to be introduced. We used the aspirate needle to decompress the femoral head osteonecrotic lesion, followed by the administration of bone marrow aspirate concentrate. This is a straightforward procedure that can be used with low risk for patient morbidity.

Potential mechanisms for predicting comorbidity between multiple myeloma and femoral head necrosis based on multiple bioinformatics

“…Osteonecrosis of the femoral head (ONFH) is a progressive debilitating lesion associated with many diseases, including trauma, steroid use, alcohol abuse and hypercholesterolemia, including some common clinical manifestations such as pain or limitation of motion [3,4] . ONFH is one of the devastating complications of systemic steroid use, and long-term steroid use leads to a hyperlipidemic state in most patients and exposes them to risk of osteoporosis and osteonecrosis [5] .…”