Core hip decompression surgery in Indore is a joint-preserving procedure used to treat the early stages of avascular necrosis (AVN) of the hip. AVN occurs when the blood supply to the femoral head (the ball of the hip joint) is reduced or interrupted, causing bone tissue to weaken and die. If left untreated, the femoral head can collapse, leading to severe arthritis and the need for hip replacement surgery.
During core decompression, small channels are carefully drilled into the affected area of the femoral head to reduce pressure within the bone, improve blood circulation, and stimulate the growth of new blood vessels. This minimally invasive procedure can help slow or stop disease progression and preserve the natural hip joint when performed in the early stages of AVN.
Dr. Sanjay Rawat (MBBS, MS Orthopaedics) is a Consultant Joint Replacement Surgeon and Consultant Arthroplasty at Shalby Hospitals, Indore, serving since 2018. With more than 7 years of orthopedic experience, he has successfully treated over 5,000 patients through knee, hip, and shoulder joint replacement surgeries and advanced orthopedic procedures.
AVN commonly affects young and active adults, making early diagnosis and timely treatment crucial. The opportunity to save the natural hip depends on the stage of the disease rather than the duration of symptoms. If you are experiencing persistent groin pain, hip discomfort, or difficulty walking without a clear cause, seek an orthopedic evaluation as soon as possible.
Core decompression is used to treat avascular necrosis of the femoral head at the early, pre-collapse stage. The problems that it faces are:
• Deep groin pain, the most common initial symptom, which is persistent and exacerbated by walking and weightbearing.
• AVN’s preference for young adults, often in their twenties to forties, with decades of joint use ahead of them.
• Known risk factors including long-term or high-dose use of corticosteroids and heavy alcohol consumption.
• Idiopathic cases.
• Involvement of both hips in a large number of patients, sometimes with the second hip still quiet.
• Normal early X-rays that falsely reassure – early AVN often seen only on MRI, delaying diagnosis.
• Unchecked natural progression: If left alone, the weakened bone is prone to collapse, causing deformity of the joint surface and development of arthritis.
Late diagnosis has a consequence: once the femoral head collapses, joint preservation is no longer possible and replacement is the only durable option.
AVN is a race between diagnosis and failure. If caught early, the natural hip can often be saved by a small operation. If caught late, a young patient faces a hip replacement decades ahead of schedule. Thus, unexplained groin pain in a young adult deserves an MRI, not just reassurance.
Core decompression is a surgical procedure for early avascular necrosis of the femoral head. Under imaging guidance, one or more narrow channels are drilled from the outer side of the upper thighbone into the dead (necrotic) part of the femoral head. Drilling releases the abnormally high pressure within the bone, a major cause of pain in AVN, and creates channels for new blood vessels and bone-forming cells to grow into the damaged area.
The biological goal is revascularization and repair — to get the blood flowing again and give the weakened segment a chance to rebuild before the joint surface caves in. Where appropriate, the procedure is combined with bone grafting into the drilled track, to give structural support to the head and to provide fresh bone-forming material. This is a minimally invasive procedure because the hip joint is never opened. It is usually done with a small incision and imaging control.
Core decompression works well early in the disease, before the femoral head has collapsed. That’s why MRI-based diagnosis is important: MRI can detect AVN at stages when X-rays still look normal. Once collapse and secondary arthritis have set in, decompression cannot restore the joint surface and the treatment becomes hip replacement.
Core decompression is the joint-preserving part of a full service for AVN. At Dr. Sanjay Rawat’s practice in Indore, it is alongside total hip replacement, the definitive answer for advanced AVN, so patients at every stage of the disease get the treatment their hip actually needs, with honest guidance about which side of the line their joint falls on.
Core decompression is a small operation that is out-of-proportionate in its benefits for early-stage AVN:
• The opportunity to completely save the native hip joint, the main promise of the procedure in pre-collapse disease.
• Marked relief of the deep, pressure-driven bone pain of AVN, which is often seen early after surgery.
• Ability to stop or slow progression to delay or prevent femoral head collapse.
• Minimally invasive procedure: small incision, short operation time, short hospital stay.
• Delaying hip replacement by years, if not avoiding it altogether, with repair works – vital for those in their twenties and thirties.
• No bridges burned: if AVN progresses despite decompression, a future hip replacement remains completely straightforward.
• A chance to treat the other hip early, as screening often detects silent AVN on the other side which is still very treatable.
Results are honestly stage dependent: the earlier the disease, the better the chances of preserving the joint. That is part of the deal of being honest – patients need to know what decompression can reasonably do for their particular stage.
Core decompression and AVN assessment under Dr. Sanjay Rawat proceeds along a defined path:
Consultation and Risk Review: History of groin pain, functional limitation, and risk associations such as steroid exposure with focused examination of both hips.
MRI-based Staging: X-rays and MRI are used to diagnose, determine the size and location of the necrotic portion, stage the disease, and evaluate the other hip.
Treatment Selection: Pre-collapse disease is matched to core decompression with or without grafting; collapsed or arthritic hips are counseled realistically for replacement.
Preparation: Anesthesia review and imaging-based planning of the drilling trajectory are performed. Clear explanation is provided about the protected weight-bearing period to follow.
Surgery: A small lateral incision is made and, under imaging guidance, narrow channels are drilled into the necrotic segment to decompress the bone. Grafting is added as indicated.
Protected Recovery: Walking with assistance and partial weight bearing are advised for a period of time to protect the drilled bone while repair takes place, along with a graded physiotherapy programme.
Surveillance: Regular clinical and imaging reviews monitor healing and both hips over time so that any progression is detected and treated early.
The path reflects the practice’s conservative-first philosophy in its purest form: save the natural joint when biology permits, monitor honestly, and hold off on replacement for the hip that truly needs it.
The care of AVN patients requires a surgeon who is equally skilled in both ends of the spectrum of treatment—joint preservation for the early hip and arthroplasty for the late one—because the critical decision is on which side of that line the patient’s joint falls.
Dr. Sanjay Rawat (MBBS, MS Orthopaedics) is Consultant Joint Replacement Surgeon and Consultant Arthroplasty at Shalby Hospitals, Indore (since 2018), with over 7 years of orthopedic experience. He has treated more than 5,000 patients through knee, hip, and shoulder joint replacement surgeries, with hip surgery being at the core of his declared specialty.
He completed his MBBS and MS (Orthopaedics) from Mahatma Gandhi Medical College and MY Hospital, Indore. He has served as Senior Consultant in Joint Replacement at Shalby Hospital, Ahmedabad, and as Assistant Professor at Amaltas Medical College, Dewas. He is an active member of the Indian Society of Hip and Knee Surgeons and recently attended ISHKS Hyderabad 2023 and Ranawat Orthopaedic Center, New York (2023).
Open, ethical advice is given to patients: where the stage allows it, decompression is recommended; where it does not, replacement is advised; and in all cases, the reasons are clearly explained.
Regular consultation facilities are also available for patients from Bhopal, Khargone, and Barwani.
Call +91-9244044779 to evaluate hip pain or diagnosed AVN on MRI.
Avascular necrosis of the femoral head (AVN) is one of the main causes of hip replacement in young adults worldwide. Therefore, joint-preserving treatment, with core decompression as its cornerstone, remains a major focus of orthopedic research and clinical practice.
The field is increasingly focused on improving the biological response of the bone. Adjunctive procedures such as bone grafting and regenerative techniques are being used alongside decompression in selected cases to enhance repair potential. MRI-based staging systems are also becoming increasingly important for accurately identifying which hips have the best chance of being preserved.
AVN is especially significant in India, where it represents a major cause of hip disease among young adults and a leading reason for hip replacement at an earlier age than typically seen with age-related arthritis. Increasing awareness that unexplained groin pain in a young adult may require MRI evaluation, along with access to age-appropriate treatment options at centres like Indore, can help improve early diagnosis and increase the chances of saving natural hip joints.
Core hip decompression surgery in Indore is a minimally invasive and joint-preserving procedure used to treat the early stages of avascular necrosis (AVN) of the femoral head. In this procedure, channels are drilled into the dying bone segment to relieve pressure, stimulate new blood supply, and support bone repair. The aim is to prevent femoral head collapse and preserve the natural hip joint, with bone grafting added in appropriate cases.
The procedure is mainly directed at pre-collapse AVN, which commonly affects young adults. Diagnosis and disease staging are performed using MRI to determine whether the hip can be preserved. Once the femoral head has collapsed, patients are realistically guided toward hip replacement as the more suitable treatment option.
Dr. Sanjay Rawat (MBBS, MS Orthopaedics) is a Consultant Joint Replacement Surgeon and Consultant Arthroplasty at Shalby Hospitals, Indore (since 2018). He has more than 7 years of orthopedic experience and has treated over 5,000 patients through knee, hip, and shoulder joint replacement surgeries. He is also an active member of the Indian Society of Hip and Knee Surgeons.
Timely diagnosis plays a crucial role in improving the chances of preserving the natural hip. Young adults experiencing unexplained groin pain or patients diagnosed with AVN on MRI should seek expert orthopedic evaluation at the earliest.
Contact: +91-9244044779
Email: dr.sanjay.rawat@gmail.com
Location: RS Bhandari Marg, Race Course Road, Indore, Madhya Pradesh 452003
Regular consultation services are also available in Bhopal, Khargone, and Barwani.
You don’t have to let persistent joint pain control your life. If you or a family member are considering core hip decompression surgery in Indore, the best first step is a structured consultation.
Dr. Sanjay Rawat (MBBS, MS Orthopaedics), Consultant Joint Replacement Surgeon and Consultant Arthroplasty at Shalby Hospitals, Indore (Since 2018), believes in assessing each patient on an individual basis and recommending surgery only after ensuring that conservative treatment options have been explored.
To make an appointment, call +91-9244044779 or WhatsApp +91-9512917493. You can also email at dr.sanjay.rawat@gmail.com.
Clinic Location:
RS Bhandari Marg, Race Course Road, Indore, Madhya Pradesh 452003.
Regular consultation services are also available in Bhopal, Khargone, and Barwani.
Start moving pain-free today.
The goal of core decompression is to relieve internal pressure within the femoral head and promote new blood vessel growth, addressing the underlying cause of avascular necrosis before the joint surface collapses.
Core decompression is most effective in early-stage avascular necrosis, before the joint surface has collapsed. Once significant collapse has occurred, hip replacement typically becomes the more appropriate treatment option.
Recovery typically involves 6 to 8 weeks of protected, limited weight-bearing followed by a gradual return to normal activity, with full recovery and pain relief developing over several months.
Yes, when performed early, core decompression can successfully halt the progression of avascular necrosis in many patients, helping to preserve the natural hip joint and delay or avoid the need for hip replacement.
A condition in which the blood supply to the ball of the hip joint is cut off, killing the bone and leading to collapse of the joint if not treated, and arthritis of the joint.
Typically a deep, constant groin pain that worsens with walking and weight bearing. Early x-rays are often completely normal which is why MRI is essential to diagnose
Walking with support and protected weight bearing for a set period of time whilst the drilled bone heals. Graded return to full activity under review.
Consultant Arthroplasty at Shalby Hospitals since 2018. He has treated AVN in its whole spectrum, decompression for the early hip to replacement for the late one. With an experience of over 7 years, he has treated more than 5,000 patients and is a member of ISHKS.
RS Bhandari Marg, Race Course Road, Indore, Madhya Pradesh 452003