![]() Vascularized fibular grafting is an invasive procedure that requires several months of healing. Patients with successful core decompression procedures typically return to walking unassisted in about 3 months and may have complete pain relief. It takes a few months for the bone to heal and, during this time, you will need to use a walker or crutches to avoid putting stress on the damaged bone. In some of these cases, the bone heals and regains its blood supply after core decompression. This depends upon the stage and size of the osteonecrosis at the time of the procedure.Ĭore decompression achieves the best results when osteonecrosis is diagnosed in its early stages, before the bone collapses. This graft is transplanted into a hole created in the femoral neck and head, and the artery and vein are reattached to help heal the area of osteonecrosis.Ĭore decompression prevents osteonecrosis from progressing to severe arthritis and the need for hip replacement in some cases. In this procedure, a segment of bone is taken from the small bone in your leg (fibula) along with its blood supply (an artery and vein). Vascularized Fibula GraftĪnother surgical option is a vascularized fibula graft. It is importat to speak with your surgeon about the available options that may be used for your procedure. Sometimes, your own bone marrow cells may be mixed together with the graft substitute to help in the bone regeneration process. There are also several synthetic bone grafts available today. The tissue may be taken from a donor (allograft) or from another bone in your body (autograft). A bone graft is healthy bone tissue that is transplanted to an area of the body where it is needed. (Right) In this X-ray, the drill lines show the pathway of the small drill holes used in the procedure.Ĭore decompression is often combined with bone and cartilage grafting to help regenerate healthy bone and support cartilage at the hip joint. (Left) Illustration of core decompression. Osteonecrosis is associated with other diseases, including Caisson disease (diver's disease, or "the bends"), sickle cell disease, myeloproliferative disorders, Gaucher's disease, systemic lupus erythematosus, Crohn's disease, arterial embolism, thrombosis, and vasculitis. Although it is not known exactly why these medications can lead to osteonecrosis, research shows that there is a connection between the disease and long-term corticosteroid use. Many diseases, including asthma, rheumatoid arthritis, and systemic lupus erythematosus, are treated with steroid medications. Overconsumption of alcohol over time can cause fatty deposits to form in the blood vessels and can elevate cortisone levels, resulting in a decreased blood supply to the bone. Hip dislocations, hip fractures, and other injuries to the hip can damage the blood vessels and impair circulation to the femoral head. It is not always known what causes the lack of blood supply, but doctors have identified a number of risk factors that can make someone more likely to develop osteonecrosis: When the diagnosis remains unclear, a diagnostic injection of local anesthetic into the hip joint may be helpful.In osteonecrosis, the bone in the head of the femur slowly dies. Occasionally, blood tests or joint fluid analysis are used to rule out other types of arthritis related to inflammatory or infectious conditions. Sometimes, your provider will recommend more advanced imaging, such as MRI. Imaging is often recommended, starting with plain radiographs (X-rays). The diagnosis of hip osteoarthritis starts with a careful history and physical examination. Altered shape of the ball and socket joint.Certain occupations or sports that place high stress on the hips. ![]() The cause of hip osteoarthritis is not well understood, but risk factors include: You may hear or feel a grating or catching sensation when you stand up, walk, or climb stairs You may not be able to move your hip through its full range of motion Hip stiffness may be most noticeable when you wake up in the morning or after a period of inactivity Your hip may hurt during or after movement Hip osteoarthritis symptoms may develop slowly or come on relatively quickly. Hip osteoarthritis is a common condition that occurs when the protective cartilage in the hip wears down, while bone around the joint grows or loses its normal smooth contours.
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