Femoral Head Decompression and Graft: Technique With New Instruments

Abstract

Introduction: Osteonecrosis of the femoral head (ONFH) is a pathology that can be treated with many approaches by the hip surgeon. Advanced decompression is a technique that aims to prevent the collapse of the femoral head and the arthrosis process of the joint, a technique already widespread and used by hip surgeons. In this study, we performed the technique with a new retractable blade and a new bone substitute as graft for the femoral head. Objective: To evaluate the technique with new instruments (EasyCore Hip®) and a calcium phosphate bone substitute (Graftys® HBS). Methods: Patients with osteonecrosis of the femoral head without major degenerative changes, such as femoral head collapse, were selected. Femoral head decompression was performed using the EasyCore Hip® retractable blade along with the calcium phosphate bone substitute as graft (Graftys® HBS). Results: The instruments proved to be reliable and reproducible, and the bone substitute presented good mechanical resistance, maintaining its temperature during the surgery. The disposable retractable blade presents variation in size and angle, which is an advantage in the removal of necrotic bone. However, we must take some precautions in order to achieve a better result. Conclusion: using EasyCore Hip® instruments and a calcium phosphate bone substitute (Graftys® HBS) is safe; however, some precautions must be taken during the use of the technique. Level of Evidence IV, Case Series.