Osteonecrosis after powered core decompression

William Mihalko, Lucy Balos, Mario Santilli, Eugene R. Mindell

Research output: Contribution to journalArticle

14 Citations (Scopus)

Abstract

A 44-year-old man with alcohol-related osteonecrosis of his left femoral head, Ficat Stage 2, was treated by femoral head decompression. During this procedure the 1/4-inch trephine driven by a power reamer became lodged in the femoral head and became hot to the touch. The trephine eventually was removed with difficulty after the decompression was completed. Four and a half years later, the patient continued to have progressive pain and difficulty ambulating. A radiograph at the time revealed a wide zone of symmetric increased density about the core decompression track. A total hip arthroplasty was done, yielding the femoral head and neck for study. Histologic sections of the femoral head and neck showed that the entire length of the core decompression track in the specimen was surrounded by 2.7 cm of unrepaired necrotic bone. The evidence suggests that extensive additional necrosis was produced iatrogenically during the core decompression with the powered trephine. Necrosis secondary to either heat generation or increased pressure along the trephine track is presented as possible mechanisms for this unusual finding.

Original languageEnglish (US)
Pages (from-to)77-83
Number of pages7
JournalClinical Orthopaedics and Related Research
Issue number412
DOIs
StatePublished - Jul 1 2003
Externally publishedYes

Fingerprint

Osteonecrosis
Decompression
Thigh
Femur Neck
Necrosis
Touch
Arthroplasty
Hip
Hot Temperature
Alcohols
Pressure
Bone and Bones
Pain

All Science Journal Classification (ASJC) codes

  • Surgery
  • Orthopedics and Sports Medicine

Cite this

Osteonecrosis after powered core decompression. / Mihalko, William; Balos, Lucy; Santilli, Mario; Mindell, Eugene R.

In: Clinical Orthopaedics and Related Research, No. 412, 01.07.2003, p. 77-83.

Research output: Contribution to journalArticle

Mihalko, William ; Balos, Lucy ; Santilli, Mario ; Mindell, Eugene R. / Osteonecrosis after powered core decompression. In: Clinical Orthopaedics and Related Research. 2003 ; No. 412. pp. 77-83.
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