Principles of Core Decompression for Osteonecrosis of the Hip

Osteonecrosis of the femoral head is a poorly understood disease with a wide range of etiologies. It has been shown to affect mostly patients in the third and fourth decades of life [1–3]. Some of the known risk factors include corticosteroid use, excessive alcohol intake, radiation therapy, chemotherapy, renal transplant recipients, systemic lupus erythematosus, human immunodeficiency virus infection, and sickle cell disease (Table 42.1) [4–9]. The most commonly used classification systems used for staging are the Ficat and Arlet, the Association Research Circulation Osseous classification (ARCO), and the Japanese Orthopaedic Association (Table 42.2).