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PATHOLOGY OF THE HIP – Treatment

Non-operative management may consist of protective weight-bearing (namely, partial weight-bearing with crutches) for six weeks then re-evaluation. Non-steroidal anti-inflammatory medications or acetaminophen may help relieve some pain. Other medication options include medications that help moderate bone loss.  However, even with protective weight bearing and medication there is a risk of the hip getting worse.

There are several surgical treatment choices available. These choices depend on the age of the patient, amount of damage to the femoral head and the stage of the disease. For some hips in early stages of the disease (Stage 1 and Stage 2) without a large area of the ball being involved one can try and preserve the native hip ball. Procedures such as core decompression (described below), osteotomy (realignment of the ball within the socket) and bone grafting attempt to save the hip ball. Once the hip reaches later stages (Stage 3 and Stage 4) total hip replacement is the treatment of choice in most cases.
Whether you choose non-surgical or surgical treatment, your doctor can help you to choose the best option for you.

Core Decompression

Core decompression is a procedure used for treating early stage avascular necrosis. It is a surgical procedure that involves a small incision.  The procedure involves using a drill through the femoral neck up into the area of dead bone in the femoral ball . Removing this central core of bone can possibly lower the pressure inside the bone, allowing for better blood flow and hopefully lead to healing of the ball with living bone. When properly done, this procedure has minimal side effects.

Patients are often restricted to partial weight bearing (crutches or walker) for 6 weeks following the procedure in order to reduce the risk of the hip bone breaking from the drill holes in the bone.  The results vary depending on the size of the area of dead bone and the stage of the disease.

Total Hip Replacement
Once the hip reaches later stages (Stage 3 and Stage 4) total hip replacement is the treatment of choice in most cases.  Further information can be found on Total Hip Replacements on this website.