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Osteonecrosis of the hip is a painful condition caused by the disruption of blood flow to the head of the femur (hip bone). This lack of blood supply leads to the deterioration of the hip joint, resulting in severe arthritic pain.
Osteonecrosis begins with the blockage of blood supply to the femoral head (thighbone), stopping the bone from receiving adequate nutrition and causing it to deteriorate over time. This deterioration of the femoral head results in the collapse of the articular cartilage coating the hip bones, leading to arthritic disability. This condition is more common in men aged 40 to 65.
Although the exact causes of diminished blood flow remain unknown, physicians have identified several risk factors that increase a person’s susceptibility to osteonecrosis. These include:
There are several surgical options available to treat osteonecrosis of the hip:
Core Decompression and Grafting
When osteonecrosis is identified in its early stages, core decompression becomes an effective treatment option to help prevent the onset of arthritis. This procedure involves the careful drilling of either one large hole or several smaller ones into the femoral head. This relieves pressure within the bone and creates pathways for new blood vessels to deliver essential nourishment.
Core decompression is often combined with bone and cartilage grafting, which can significantly contribute to the regrowth of healthy bone and the reinforcement of cartilage within the hip joint. The procedure entails using healthy bone tissue, which can be sourced as an allograft (donor) or autograft (from another part of the patient’s body), and skilfully transplanting it into the affected hip region.
Today, there are also various synthetic bone grafts available, expanding the choices available for patients. Additionally, some procedures involve the blending of bone marrow cells with the graft material, aiding the process of bone regeneration.
Your surgeon will discuss all potential options for your procedure to ensure the best possible outcome.
Vascularised Fibula Graft
An alternative surgical treatment involves extracting a segment of the smaller bone in your leg, known as the fibula, along with its connected blood vessels (an artery and a vein), and grafting it into a surgically crafted hole in the femoral neck and head. This process reconnects the artery and vein, fostering healing within the region affected by osteonecrosis.
Total Hip Replacement
When osteonecrosis has progressed to the stage of a collapsed femoral head, a total hip replacement becomes the optimal treatment choice. In this procedure, the surgeon removes the compromised bone and cartilage and replaces them with artificial joint components crafted from metal or plastic, aiming to restore your hip’s natural functionality.
To learn more about the hip replacement procedure, as well as what you can expect prior to, during, and after the surgery, please visit our Hip Replacement page.
For further inquiries or to arrange a consultation, please contact Professor Al Muderis’ office at +61 2 88829011 or book an appointment online.
X-ray facilities at all locations | Urgent appointments available if necessary.
Professor Munjed Al Muderis is an orthopaedic surgeon and a clinical professor at Macquarie University and The Australian School Of Advanced Medicine. He specialises in hip, knee, trauma and osseointegration surgery. He is a fellow of the Royal Australasian College of Surgeons and Chairman of the Osseointegration Group of Australia.