Biomechanical Analysis of Hip Core Decompression Techniques and Fracture Risk

+ 1 Sikes, CV; 2 Brown, PJ; 2 Danelson, KA; 1 Seyler, TM; 1 Mannava, S; 1 Jinnah, RH; 2 Stitzel, JD; 1 Lang, JE +Wake Forest University Orthopaedic Surgery, Winston-Salem, NC, 2 Wake Forest University Biomedical Engineering, Winston-Salem, NC [email protected] INTRODUCTION: Avascular Necrosis (AVN) of the hip is a condition involving disruption of the blood supply to the femoral head with subsequent collapse of the subchondral bone and resultant pain. Early detection in the pre-collapse stage and treatment with a 810 mm trephine or cannula, inserted under fluoroscopic guidance, decompresses the lesion allowing for reversal or delayed progression of the disease [1]. However, the use of these large-diameter trephines can weaken the femoral head and neck leading to stress fractures [2]. Recently, a new surgical technique using multiple small diameter holes has also produced promising clinical results [2,3]. The purpose of the present study was to biomechanically evaluate large versus small hole decompression techniques with respect to proximal femur integrity and resistance to fracture. We hypothesized that the two techniques would not differ biomechanically.