Core Decompression (AVN)

What Is Avascular Necrosis (AVN)?

Avascular necrosis (AVN) of the hip occurs when the blood supply to the femoral head (the ball of the hip joint) is reduced or cut off. Without enough blood, the bone tissue dies, leading to pain, stiffness, and eventually collapse of the hip joint if untreated.

What Is Core Decompression?

Core decompression is a surgical procedure designed to relieve pressure inside the bone, improve blood flow, and encourage healing. It involves drilling one or more small channels into the femoral head to reduce pressure and allow new blood vessels to grow. Sometimes bone grafts or biologic materials are added to support healing.

When Is It Recommended?

Core decompression may be suggested if:

AVN is diagnosed in the early stages, before the bone collapses.
You have persistent hip pain that does not improve with medications or physiotherapy.
Imaging (MRI, X-rays) shows reduced blood supply but preserved bone shape.
You are younger and want to delay or avoid hip replacement surgery.

The Procedure Step-by-Step

Evaluation – MRI and X-rays confirm the stage of AVN.
Anesthesia –General or spinal anesthesia is given.
Decompression – Small tunnels are drilled into the femoral head to relieve pressure.
Optional grafting – Bone grafts or stem-cell–based materials may be placed to promote healing.
Closure – The incision is closed, and recovery begins.

Recovery and Rehabilitation

Hospital stay:Usually 1–2 days.
Weight bearing:Often limited for several weeks to protect the hip.
Physiotherapy: Helps restore movement and strengthen muscles.
Outcome: Works best in early AVN; may delay or prevent the need for hip replacement.

Benefits

Relieves pain and pressure in the hip.
Improves blood flow to the femoral head.
Preserves the natural hip joint.
May delay or avoid hip replacement surgery.

Risks & Considerations

Effectiveness depends on the stage of AVN.
Possible complications: infection, fracture, or incomplete pain relief.
In advanced AVN (with bone collapse), hip replacement may still be required later.

Key Message for Patients

Core decompression is a safe and effective treatment for early-stage AVN of the hip. By relieving pressure and restoring blood flow, it can reduce pain, preserve the natural joint, and delay the need for hip replacement. Success depends on early diagnosis and commitment to rehabilitation.

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