Since 1977, we have performed twenty-one core decompressions in
seventeen patients who had stage-I or II ischemic necrosis of the femoral
head. The diagnosis was confirmed histologically in all but one patient.
After a mean length of follow-up of thirty-nine months, healing was evident
in eight hips (40 per cent) but not in the other twelve. All twelve hips
required additional surgical treatment; the average length of time before
the additional treatment was required was 9.2 months. The results of two
intraoperative diagnostic tests (intramedullary pressure and saline stress
tests) did not correlate with the results of biopsy. A perioperative
fracture through the site of the decompression occurred in one of the
twenty-one hips. Given the relatively poor long-term results and the
considerable morbidity that was associated with core decompression, this
treatment cannot be recommended.