Poster 222: High Rates of Conversion to Total Hip Arthroplasty After Core Decompression for Avascular Necrosis of the Hip

Objectives: Avascular necrosis (AVN) of the hip is caused by interruption blood flow to femoral head, resulting in pain, loss joint function, and eventual arthritis. Core decompression may be performed for early AVN with a goal improving symptoms potentially delaying need THA. The effectiveness this procedure generally not well understood given relatively rare nature AVN. predictors conversion THA after core are defined. also without devastating complications, including neck fractures, though estimation true incidence complications has been limited sample sizes prior investigations. purpose study utilize large payor database determine time compression, assess THA, examine decompressions. We hypothesize that less than 25% patients who had will convert at two year follow up, we age predictor Methods: Using Current Procedural Terminology codes, queried Mariner PearlDiver dataset underwent from 2010 2020. Patient demographics were recorded subsequent within 2 years surgery tracked. demographic factors, including, age, sex, obesity, diabetes, steroid use, tobacco or alcohol evaluated as possible International Classification Diseases, codes used identify 90 days decompression. Multiple linear regression was test if patient significantly predicted Cox-Survival plot performed. Statistical significance defined p<.05. Results: Between 2010-2020, 555 Within decompression, 209 converted (37.6%) one hemiarthroplasty. Average converting 47.7 compared those did 43.4 (95% CI 2.1 – 6.2 years, p < .001). Most between 50-59 (Figure 1). Age only risk factor following variables associated: Sex, fracture, use. Cox survival demonstrated high highest first 200-days 2). 90-day complication rate 2.9% 5.2%. most common fracture both points (68.7% compilations 75.9% years). There no significant difference days. At smoked (OR 0.39 = .02) 0.23; more likely have complications. Conclusions: failure over third years. Patients older 50 rates While overall low should counseled regarding fracture. Further research needed success