Details

Autor(en) / Beteiligte

• Benignus, C
• Lüring, C
• Beckmann, J

Titel

Core decompression ("conventional method") in atraumatic osteonecrosis of the hip

Ist Teil von

• Operative Orthopädie und Traumatologie, 2020-04, Vol.32 (2), p.89-95

Ort / Verlag

Germany

Erscheinungsjahr

2020

Link zum Volltext

Quelle

Alma/SFX Local Collection

Beschreibungen/Notizen

• Retrograde drilling of a necrotic zone within the femoral head to reduce intraosseous pressure and stimulate revascularization. Atraumatic osteonecrosis of the hip ARCO stage I (reversible) and ARCO stage II (potentially reversible) with a medial or central necrotic zone <30% or ARCO stage III with a subchondral fracture for reduction of pain. ARCO stage III C, ARCO stage IV (secondary osteoarthritis), stage-independent necrotic zone > 30%, infections. Supine position. Visualization of the necrotic zone via an image intensifier, approach is determined by using a Kirschner wire, laterodorsal skin incision on a level with the wire, longitudinal incision of iliotibial band and vastus lateralis muscle, drilling the necrotic zone with a 2-3 mm Kirschner wire, optionally placing more wires or a hollow drill, wound closure. Partial weightbearing with 20 kg for 6 weeks due to risk of fracture, followed by avoidance of jumping or sprinting for another 6 weeks; physiotherapy from day 1 after surgery, thromboembolic prophylaxis until full weightbearing is possible. Results are dependent on ARCO stages and are promising in early stages.