Low Rate of Return to Impact Activity Following Core Decompression for Femoral Head AVN in Military Servicemembers
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Authors
Shaw, K. Aaron
Mottern, Edward
Parada, Stephen A.
Burks, Robert
Dumont, Guillaume
Waterman, Brian R.
Nho, Shane J.
Subjects
Advisors
Date of Issue
2019
Date
2019
Publisher
Oxford University Press
Language
en_US
Abstract
Femoral head avascular necrosis (AVN) is a debilitating disease with core decompression commonly performed for early stage disease. However, the ability to return to high-activity levels following treatment is largely unknown. Materials and Methods: Active military patients undergoing core decompression for femoral head AVN were reviewed. Demographic variables were identified and visual analog pain data was collected at a minimum of 2-year post-surgery or prior to total hip arthroplasty (THA). Patient outcomes, need for THA, and ability to remain on active service were recorded from chart review. Imaging studies were reviewed to classify the lesion stage and size for correlation with progression to THA or discharge from military service. Results: A total of 29 active duty patients met inclusion criteria (22 male, 7 female; 32.3 years). Seven patients (24%) progressed to THA and they were more likely to have bilateral disease (86%) and be older (35.4 years versus 31.2 years). At final follow-up, 86% of patients had significant hip-related activity restrictions, with only 6 (21%) remaining on active military service. Neither Steinberg stage nor modified Kerboul necrotic angle was associated with progression to THA or military discharge. Conclusion: Military servicemembers undergoing core decompression for femoral head AVN experienced mild clinical improvement with moderate survivorship from THA (74%) at mid-term follow-up. However, servicemembers have a low likelihood of returning to preoperative physical function and running activities (13.7%). Older patients and those with bilateral disease were at a higher risk of progressing to THA.
Type
Article
Description
The article of record as published may be found at https://doi.org/10.1093/milmed/usy163
Series/Report No
Department
Mechanical and Aerospace Engineering (MAE)
Organization
Naval Postgraduate School
Identifiers
NPS Report Number
Sponsors
Funder
Format
6 p.
Citation
Shaw, K. Aaron, et al. "Low Rate of Return to Impact Activity Following Core Decompression for Femoral Head AVN in Military Servicemembers." Military medicine 184.1-2 (2019): e243-e248
Distribution Statement
Rights
This publication is a work of the U.S. Government as defined in Title 17, United States Code, Section 101. Copyright protection is not available for this work in the United States.