ArticleOperative Orthopadie und Traumatologie2020
[Modified advanced core decompression (mACD)].
Article in Operative Orthopadie und Traumatologie, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
4 citing papers in PubMed, 10 citations in OpenAlex.
- Comparison of the Efficacy of Different Combined Therapies Based on Modified Core Decompression for the Treatment of Early-stage Nontraumatic Osteonecrosis of the Femoral Head: A Retrospective Clinical Study.Orthopaedic surgery · 2024Article
- Hip Arthroscopy Debridement Combined with Multiple Small-Diameter Fan-Shaped Low-Speed Drilling Decompression in the Treatment of Early and Middle Stage Osteonecrosis of the Femoral Head: 14 Years Follow-Up.Orthopaedic surgery · 2024Article
- [Osteonecrosis].Der Orthopade · 2021Article
- Arthroscopic assessment of concomitant intraarticular pathologies in patients with osteonecrosis of the femoral head.Journal of hip preservation surgery · 2020Article
Corrections and comments
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Authors and funding
2 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveThe modified advanced core decompression (mACD) combines the advantages of a low invasive core decompression with maximal removal of osteonecrotic bone and a biologic reconstruction of the resulting bone defect. INDICATIONS: Avascular (atraumatic) osteonecrosis of the femoral head (ARCO stage II). CONTRAINDICATIONS: Subchondral fractures (ARCO stage III); advanced osteoarthritis (e.g., ACRO stage IV); persisting risk factors such as high-dose corticoid therapy, chemotherapy, alcohol abuse; open growth plates; history of side effects or intolerance to components of the applied bone substitute; lack of patient compliance; osteomyelitis or other septic conditions. SURGICAL TECHNIQUE: Supine positioning on the operation table, skin disinfection, and sterile draping. Skin incision and core decompression using a 3.2 mm guide wire. Removal of a bone cylinder from a nonaffected area of the femoral neck using a hollow trephine. Drilling of the osteonecrotic area over the applied wire up to 5 mm to the subchondral bone under fluoroscopy, insertion of an expandable bone knife and removal of the osteonecrotic bone supported by a curette. Bone grafting of the autologous bone into the subchondral defect zone and filling of the drill canal by resorbable bone substitute. POSTOPERATIVE MANAGEMENT: Bed rest for 24 h, then partial weight bearing (20 kg) on crutches for 2-6 weeks depending on the bone quality in the defect zone and the applied bone substitute.
resultsMidterm superiority (2 years) in hip survival of the mACD over advanced core depression and core depression, especially in ARCO stage II.
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