Background

Approximately 20,000 to 30,000 new patients are diagnosed with osteonecrosis of the hip each year. Patients with osteonecrosis often are younger adults, and bilateral presentation is common. Although total hip arthroplasty has been successfully used to manage hip osteonecrosis, hip preservation improves outcomes and quality of life while maintaining the native hip joint. Osteonecrosis of the hip typically follows a progressive course; however, core decompression may be pursued in an attempt to stop this progression. Hip arthroscopy can be performed in combination with core decompression to manage intra-articular pathologies and also may help improve localization of the lesion.

Purpose

This video provides an overview and case presentation and demonstrates arthroscopic hip labral repair with core decompression for osteonecrosis of the femoral head.

Methods:

The physical examination, diagnosis, and treatment options for osteonecrosis in a patient with a labral tear are discussed. The case presentation of a 35-year-old patient with osteonecrosis and a labral tear is discussed. After failed nonsurgical management, the decision to pursue hip arthroscopy with labral repair and arthroscopic-assisted core decompression was made.

Results

Hip arthroscopy with labral repair and arthroscopic-assisted core decompression was successfully performed in a single surgical setting. Postoperative clinical follow-up demonstrated reduced pain and improved function.

Conclusion

Patients with early osteonecrosis of the femoral head can be safely treated via arthroscopic-assisted core decompression.