core decompression

[majveg9]

Hi I recently started having bad hip pain. Was referred to ortho who did MRI and said had pre collapse avn. He recommended core decompression without any bone graft BC he said that from what he's seen no better outcome with graft. Everything I've read online says with bone graft. So I'm kinda confused. Does anybody know how the outcome usually is wo bone graft. Also he said I'd have to be on crutches for 6 weeks. What kind of pain should I be expecting?

 

[texasvet]

@majveg9 another member @robstinson is 27 and just had a core decompression, about 4 days ago. He can probably give you an idea about pain. He didn't mention a bone graft in his post, but he is now tagged and hopefully will reply to your post.

 

[Josephine]

Hello majveg9 and welcome to BoneSmart!

I have a feeling that using bonegraft is going out of favour as the site where the graft was taken often causes more pain and problems than the hip! So they now use a variety of implants with the intent that they will stimulate the growth of new bone.

This is what it looks like

However, most surgeons require and extensive period of non-weight bearing not only which, for some reason the procedure is quite painful. Added to which, my information is that they are not hugely successful and many require a hip replacement very soon after.

May I ask, do you know what grade your AVN is? It's scored like this

And have you thought about having a hip replacement?

 

[majveg9]

Hi thanx for the reply the surgeon told me it was type B. Luckily its pretty collapse. I have thought about hip replacement but he's saying I'm too young which I find strange BC from what I've learned online plenty of people me age are getting them and from what you say if the core decompression is not very successful why put myself thru 2 surgeries. Plus he tried to tell me this procedure is not very painful which doesn't sound true. Should I get a second opinion?

 

[Jamie]

I definitely thing you should get a second and maybe even a third opinion. This is always a good idea for something so serious as joint surgery. Just be sure that your other opinions come from doctors who are in no way associated with each other. That means they don't practice at the same hospital, aren't from the same clinic and possibly are even in different cities. You want totally independent opinions!

Another thing to do when checking for alternate opinions is to find doctors who specialize in younger patients. They seem to have a much better understanding of a situation like yours. You can find this information by checking their websites or by calling their office and talking with their nurse.

 

[Josephine]

The problem is that there are surgeons who are 'enthusiasts' about certain procedures and will recommend them regardless. I'm not saying they would deliberately mislead you but they are really committed to such a procedure being the 'best' and better than a replacement which is what they believe. But there are others who would disagree and for much the same reasons as I have offered. Our experience on here, from members who have had CD done, is that they are by no means pain free! Far from it! If you go into the hip recovery forum and find a thread prefixed with "Core Decompression" and click on that prefix, you will get a search of all threads with the prefix. I suggest you read them.

 

[robstinson]

Hey, I was also diagnosed with pre collapse AVN in my right hip. Got two opinions and both recommended either medicine (fosamax) or decompression. Because I'm only 28 with no collapse they really weren't prepared to replace it. I did some thinking as well as some reading and I finally decided that I was going to have the core decompression, no graft just the decompression itself.

I just had mine last Friday and to be honest it really isn't that bad. My pain was never that bad to begin with before the surgery, it was more of an annoyance but I knew that I had to do something about it or else I risked a collapse. I'd say the worst part so far is just the muscular soreness around the incision that is rough, so I've been stretching it out trying to get some mobility back and it's been working. I'm sure most doctors will tell you that you'll need crutches for 4-6 weeks which is what I've heard from both as well.

Seems like the hardest part is remembering to not put pressure on it, because I honestly have minimal pain at the femoral head itself so I can stand without crutches but i know for the best case healing I need to stay off it.

If you have any other questions feel free to let me know, good luck.