The treatment plan is strongly influenced by how much of the head is involved, whether a collapse has already been developed, and whether any sign of remodellation in the head can be detected. In moderate case, the avoidance from load (by using walking frame or elbow crutches) will do, until the femoral head is remodelled and healed.
In most of the cases, however, the vessel ingrowth and remodellation fails; in this case, surgery is generally needed. As long as the collapse of the upper head section has not developed, the circulation of the involved area can be restored by drilling of the head. This procedure can be performed under general or spinal anaesthesia; a very tiny (maximum few centimeter long) cut is needed for the exposure, and the duration of hospital stay is only 3 to 5 days. However, a longer period (months) of load avoidance is required after the procedure.
If the collapse of the head is evident, the only solution is the removal of the femoral head, and hip prosthesis implantation, as the cartilage surface after the collapse deteriorates rapidly, causing massive pain and loss of the muscle strength.
This post is also available in: Hungarian