Hip Preservation Surgery
A bone-preserving procedure for early avascular necrosis of the femoral head — drilling a core to relieve intraosseous pressure and restore blood flow before the femoral head collapses.
What is Hip Preservation Surgery ?
Avascular necrosis (AVN) of the femoral head is caused by disruption of the blood supply to the femoral head, leading to death of bone tissue and eventual collapse of the head if untreated. Core decompression is the most widely performed joint-preserving procedure for early-stage AVN, performed before the femoral head has collapsed (ARCO Stage I–III). By drilling a core cylinder through the femoral neck into the necrotic zone, the procedure reduces elevated intraosseous pressure, improves venous drainage, and promotes revascularisation of the affected segment — slowing or halting progression and potentially avoiding hip replacement altogether.
Suitable for patients with early-stage avascular necrosis of the femoral head (ARCO Stage I, II, or early III) before femoral head collapse — confirmed on MRI. Not appropriate for advanced or collapsed femoral heads where hip replacement provides more reliable outcomes.
How the Procedure Works
MRI Confirmation
MRI is essential to confirm the diagnosis, stage the disease, and assess lesion size and location before proceeding.
Patient Positioning & Approach
Patient positioned on a traction table; a lateral approach to the greater trochanter is used under fluoroscopic guidance.
Core Drilling
A 10 mm core drill or multiple 3 mm drill bits are introduced through the greater trochanter, across the femoral neck, and into the necrotic lesion — removing the dead bone and relieving pressure.
Biological Augmentation (Optional)
The decompression track can be augmented with autologous bone graft, demineralised bone matrix, platelet-rich plasma, or concentrated bone marrow aspirate to stimulate healing.
Protected Mobilisation
Toe-touch or partial weight-bearing for 2–4 weeks; progressive loading thereafter.
Outcomes
Who Needs This Treatment?
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Preserves the native hip joint — avoids or delays hip replacement
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Minimal incision — outpatient or 1-night admission
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Can be combined with biological augments to improve revascularisation
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Most effective when performed early — before femoral head collapse
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Allows return to protected weight-bearing in 2–4 weeks
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Significantly reduces intraosseous pressure and pain
"Core decompression works best when we intervene early. An MRI showing early AVN should prompt urgent referral — the window of opportunity to preserve the femoral head is narrow, and once collapse occurs, replacement becomes the only reliable solution."
— Dr. Satish Reddy Gandavarapu, Senior Orthopaedic Consultant and Trauma Surgeon , Lux Hospitals, Hyderabad
Hip Preservation Surgery Cost in Hyderabad
The cost of hip preservation surgery in Hyderabad depends on the complexity of the condition, the technology and implants used, and the care needed before and after the procedure. Your treating doctor will share a personalised estimate after your consultation.
| Procedure | Approximate Cost Range |
|---|---|
| Hip Preservation Surgery | Shared after consultation |
The final cost may vary depending on your individual condition, findings during the procedure, and whether any additional procedures are required.
Factors That Influence Hip Preservation Surgery Cost
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Complexity and severity of the condition being treated
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Type of anaesthesia and surgical technique used
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Pre-operative investigations and evaluations required
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Duration of hospital stay and post-operative care needed
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Any additional procedures performed during the same surgery
Is Hip Preservation Surgery Covered by Insurance?
Hip Preservation Surgery may be covered by health insurance when it is performed for a medically necessary condition. Coverage depends on your insurance policy, inclusions, and the approval process.
- Checking your policy coverage
- Cashless approval process
- Required documentation
- Insurance-related queries before the procedure
Dr. Satish Reddy Gandavarapu
Orthopaedic & Joint Replacement Surgeon
During consultation, Dr. Satish Reddy Gandavarapu will evaluate your symptoms, medical history, and investigation reports to determine whether Hip Preservation Surgery is right for you, and will guide you on the expected outcomes and estimated cost based on your individual condition.
Common Questions
Frequently Asked Questions
Not sure which treatment is right for you?
Book a consultation with Dr. Satish Reddy and get a personalised treatment plan.