What is Core Decompression and Cell Therapy for?
Core Decompression and Cell Therapy are two out of the string of treatments for osteonecrosis, or what is also known as avascular necrosis of the hip. Before we dive right into the thick of it, let us first understand the condition.
Osteonecrosis, or avascular necrosis (AVN), develops when the head of the femur is deprived of blood supply. Without the necessary nourishment, the femoral head dies, it will gradually collapse, and may lead to degenerative changes. This can cause severe pain and disability, much like arthritis does.
Osteonecrosis can affect anyone, but it is more common in individuals between the ages of 40-65. Men develop osteonecrosis of the hip more often than women. Patients with osteonecrosis that is caught in its very early stages, or before the femoral head collapses, are potential candidates for Core Decompression and Cell Therapy.
Core Decompression is done under spinal or general anaesthesia. The patient is placed on their back or in a supine position. The surgeon may use live x-ray or fluoroscopy to serve as a guide during the procedure. He then creates a small incision on your hip and a guide wire is passed from the incision through the neck of the femoral bone to the necrotic area in the femoral head. A hole is then drilled along the wire from which the necrotic bone is removed. This immediately reduces pressure and it also creates a space for new blood vessels to grow and nourish the affected bone.
The cavity that is left behind in the bone is sometimes filled with bone graft taken either from another part of your body or from a donor. In some cases, synthetic bone graft material is used. The incision is then closed with sutures
Meanwhile, if cell therapy is done alongside core decompression, the collection of bone marrow or mesenchymal cells from the iliac crest is accomplished by the use of a single beveled aspirating needle, or a standard 10 ml syringe. It is prepared by rinsing it with an anticoagulant solution. The needle is positioned at a 45-degree angle and successive aspirations are done to afford aspiration from the largest possible space. A trocar is used to position the stem cells to where they are supposed to be placed before it is administered.
Any surgery involving bones, muscles or tendons pose a risk for re-injury or injury to another part in the surrounding area. Infection, bleeding and loss of function are also possible with this procedure. There is also a chance that there will be damage to the nerves and blood vessels in the legs and hip. Rejection of the bone graft is also possible with core decompression.
Cell therapy posed no risk since this is an autologous donor, which means that the cells are the patient’s own. This prevents the possibility of allergic reactions or rejection. The procedure is also minimally invasive percutaneous injection and not a major surgery, hence there are lesser risks.
To be well-prepared for surgery, it is best to understand and discuss this with your doctor. He can walk you through what will happen during the surgery and what to expect afterwards. You may undergo scans and pre-operative testing to determine the best approach in restoring blood flow and to relieve pressure in your hip. Once it is determined that you are a candidate for core decompression, you are advised not to eat or drink anything after midnight before surgery.
After the operation, you may be advised to use crutches or walkers for 6-12 weeks to prevent weight bearing at the hip joint until the femur joint heals completely. This may require time off work and other physical activities. You may resume your regular activities 3 months after the surgery. Therefore, the key to a speedy recovery is to adhere to post-surgical instructions and to prevent undue stress on the affected area.
Pain is your body’s way of telling you that something is not right. Don’t just brush it off and risk the chance of compromising your movement and interupting your daily activities. Get it checked today for the right intervention the soonest possible time. Book your appointment with Dr. Dutton, here.
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