Core decompression. Has it worked for any of you?

[V4kerker]

Hi everyone,I have bilateral AVN I think stage 3 and the right femur head has collasped.Would like to know if anybody has had any good results with core decompression.

I was going to go for core decompression on the right and left hip.But after 2nd opinion the 2nd OS said I'd be back in 6 months wanting a right THP.Well after getting over the shock of the news about needing new hips I'm going to set up a date for RTHP not sure what to do about the left,because I have only mild discomfort with the left and the right is only painful after a day of trying to be 20 years old.

I'm having a hard time somedays thinking about getting THP when I'm walking ok but just can't act young and stupid and pay the price the next day.

Thanks for any advice.

 

[UTdave]

How old are you? Older than 20, I would guess! ;-)

If I were over 50, I would skip any "preservation" surgeries and go straight to THR or resurfacing. Just because their longevity would indicate you may likely need only one, maybe two procedures (if all goes well, of course). If I were under 30, I would strongly look at them.

I'm sorry that I have no familiarity with this decompression. . .

 

[UTdave]

Oh, and if your pain is so mild, I wonder if now is the time. But best to have someone lined up who knows you and can get you scheduled for surgery when the need arises. . . and if AVN is the diagnosis, it will arise eventually.

 

[Texas]

Welcome me either but Im sure someone will post that can help you...Good Luck to you...Im so sorry about you situation/ But Im sure you can get it all straight and we are all here to support you .......

 

[ronhall51]

Hi everyone,I have bilateral AVN I think stage 3 and the right femur head has collasped.Would like to know if anybody has had any good results with core decompression.

I was going to go for core decompression on the right and left hip.But after 2nd opinion the 2nd OS said I'd be back in 6 months wanting a right THP.Well after getting over the shock of the news about needing new hips I'm going to set up a date for RTHP not sure what to do about the left,because I have only mild discomfort with the left and the right is only painful after a day of trying to be 20 years old.

I'm having a hard time somedays thinking about getting THP when I'm walking ok but just can't act young and stupid and pay the price the next day.

Thanks for any advice.

I can only give you my perspective i wasnt a ten on the pain meter closer to a three.but i had a serious limp and my mobility was getting more limited.I could of lasted a few more years like that but why??? i rather spend the 4 or 5 months now and ger back to my active life.Then live in the shadow of the inevitable for 5 years.

 

[Jamie]

Hi, V4kerker....and welcome to BoneSmart. Sorry to hear about your AVN. I think UTDave gave you good advice. Our forum nurse, Josephine, may have some additional information from a medical perspective.

Please post any time you have a question or concern....or just to chat! We'll be here for you.

 

[Josephine]

Yes, it would be nice to know your age but nevertheless, many hip surgeons tend to refer to core decompressions as a two stage hip replacements meaning they are often a only a very temporary measure as your 2nd opinion said. I seriously would check out resurfacing though.

The other factor is to make a list of the things you would normally be doing, that you like doing and then cross off those things that you can no longer do or generally think twice about doing because of your hips. Include the very mundane stuff like chores and shopping because they all count. When you've done that, you'll have a pretty good idea of how much this problem is affecting your life which should help you make up your mind.

Personally, though my knee wasn't all that bad and my already limited life wasn't so terribly restricted, I got my knee done much earlier than is customary but I think it was for the best and I would encourage others to do the same rather than wait until their lives are a pale shadow of what they should be.

 

[tonerika]

I am not sure what core decompression is. I am 41 and have AVN. Just discovered it around Christmas. The OS tried "revitalizing" as Ms. J called it in March. I was getting better then started getting worse. The OS said I could either live with the pain with NO meds or have THR. So I set the surgery for Sept. Now in the past 4 days it feels just a little better. (Go figure!) SO, cancel the surgery or not? I decided that even with the pain on a slightly lesser scale, there is still pain. And it could get worse any given day. If surgery gets rid of the pain and puts my life back to normal, I am GOING for it. After all, I have to have THR sometime, whether it is now or down the road, so why not now???? Dont know if that helps you or not. Good luck!!

 

[V4kerker]

Thanks for the replies.
I'm 45 and I think I'm stage 3 AVN.I'm going for a RTHP not sure about my left.My left knee is bothering me the most right now because of my Gait some times is poor.I also got a small tear in my left meniscus back in 2004.I've got some degenerative lower discs also.

The 2 doctors I saw said that the core decompression could work but not with a high succes rate at my stage of AVN.

The more research I do the less optimistic I'm about core decompression.Just would like to hear from some people who had it done and see if it's worked for them.

I'm having my first OS do the RTHP he does about 75-100 hips a year and uses BOIMET metal on metaland plastic.He did my friends TKP and has been trouble free.

My biggest fear is post op stuff(blood clots,infections,joint misalingment) and being in more pain then now.

I'm starting to see that some people just put off the THP/TKP for to long when they just wasted time away being idle for to long.

Thanks again for the replies.

 

[V4kerker]

I've got another question if I decide on LTHP also should I do both at the same time or one at a time?The OS said he could/would do both at one time.My job isn't a problem I have a good sick plan at work.Plus my job is sitting/standing for 12 hours a day.:pzld:

Thanks V4kerker

 

[Jamie]

I'm not sure you're going to find anyone on our forum who has experienced the core compression. But here is a link to an broken link removed: https://osteonecrosisavnsupport.org/index.htmlthat I found to be very helpful when I was diagnosed with it in my knee. There is a question and answer section you can click on in the bar at the left of the home page.

If I knew I needed both hips done, my choice would be to do both at once and be done with it. Others have done one at a time and have been happy with it...it just drags recovery out some. It's really a personal choice. One thing to consider is how much help you will have for the first few weeks of recovery. You'll need it. A rehab center sometimes is a good option. Would you like me to make a separate thread for you with that question? You might be more likely to get replies specific to it than with it buried in here.

 

[TBONE]

v4kerker--I can't opine on the decompression as I have never heard of it. I had bilat THR and I can tell you that it is not 2x as bad as a single hip replacement. In fact, it is only about 10-25% more difficult, I would guess. But my hips were both worn out completely and I needed both replaced. I would not want to have to go through a second surgery unless I had to. So, for me, bilateral hip replacement was an easy and clearly the correct choice.

 

[V4kerker]

Jamie thanks for the link.The only problem with the site is they'er not taking any new members right now because of web site upgrades.
I would sure like to hear about some succes stories.Mostly I wish I knew what caused my AVN and how to stop it,because it could attack more/all of my joints.:pzld:

I go to see the OS Friday to come up with a surgery plan.I may ask him about seeing a Dr.Mont(he's up on core decompression).

This AVN is some funny stuff.Wedensday I walked 3 miles and Thursday I rode my standup jetski and today no major pain.The discomfort usually goes away when I get the blood flowing in the legs which makes some sense of my problem.Then there's the day after sometimes I just want to stay in a chair.

Thanks again

 

[Jamie]

I was really scared when I first received my diagnosis of AVN. I immediately went on the internet and read some really bad things about people who got it in several joints. I feared it would spread and affect not only my knees, but hips and back as well!!

I later learned that happens mostly with people who have been on steroids for prolonged periods of time (that wasn't me). After I found better doctors than the one who did my scope that resulted in the AVN, I was correctly told not to worry about it. The necrosis was small and only in my knee. It was frankly not a factor or problem at all from that point on, as the bad bone was cut away during the knee replacement and it is gone....hopefully never to return. I had two orthopedic surgeons tell me that the AVN would NOT spread to other joints.

So, read about it. Ask your surgeon questions (or Josephine, our forum nurse, as she may have had some experience with it), but if you have not been on Cortisone or other steroids for extended periods, I believe it won't "spread" to other joints.

 

[Josephine]

Actually AVN usually a joint specific condition. Hips are the most vulnerable because the head of the femur has an odd structure and an odd blood supply.

The blood supply is not rich so any problem like arthritis or micro-trauma that causes any degradation of the bone in the head can disrupt the blood flow and so the bone begins to die back. This is also because of how the head is 'out there' on the angled neck which makes the loading extreme. No other joint is like this although a similar thing can occur in the knee because that is also a weight bearing joint. The use of steroids or addiction to hard drugs or alcohol can have the effect of softening the bone which is the prelude to AVN. Post menopausal women (and men!) can also suffer this as a by product of osteoporosis.

Core decompression is a procedure whereby new bone is implanted along the neck of the femur in an attempt to regenerate the blood supply. Usually a piece of bone is taken from elsewhere in the body along with blood vessels that can be joined to the blood vessels around the upper end of the femur. It's a bit a like an organ transplant except it comes from your own body.

The problems with this is that sometimes the bone graft doesn't survive or doesn't meld with the bone around it and the arthritic processes continue to progress.