Core Decompression
This procedure removes the inner layer of bone, which reduces pressure within the bone, increases blood flow to the bone, and allows more blood vessels to form. It works best in people who are in the earliest stages of AVN, often before the collapse of the joint. This procedure sometimes can reduce pain and slow the progression of bone and joint destruction in these patients.
Osteotomy
This procedure reshapes the bone to reduce stress on the affected area. Recovery is lengthy and the patient's activities are very limited for 3 to 12 months. This procedure is most effective for patients with advanced AVN and those with a large area of affected bone.
Bone Graft
A bone graft may be used to support a joint after core decompression. Bone grafting is surgery that transplants healthy bone from one part of the patient, such as the leg, to the diseased area. Commonly, grafts (called vascular grafts) that include an artery and veins are used to increase the blood supply to the affected area. There is a lengthy recovery period after a bone graft, usually from 6 to 12 months. This procedure is complex and its effectiveness is not yet proven.
Arthroplasty (Total Joint Replacement)
This surgery is the treatment of choice in late-stage AVN and when the joint is destroyed. In this surgery, the diseased joint is replaced with artificial parts. It may be recommended for people who are not good candidates for other treatments. Various types of replacements are available.
