Efficacy of core decompression as treatment for osteonecrosis of the hip: a systematic review.

Core decompression (CD) for the treatment of osteonecrosis of the hip has been a surgical option since the 1960s. We performed a systematic review to evaluate CD with regard to pain relief, need for total hip arthroplasty (THA), and lesion size and Ficat stage. Only four articles of level IV evidence (139 total cases) met inclusion criteria. Three reported improvement in outcomes. Overall average outcomes were only "good" in one study and either "fair" or "poor" in the others. One-fourth (25.8%) of patients required THA. Patients with necrotic lesion size <50% had best outcomes with CD. Although CD may become a standard treatment option to prevent THA in early stages of ON, there are not currently rigorous studies that provide long-term outcome measures.