Shall we wait until the head of the femur is completely crushed in idiopathic necrosis of the femoral head?

Although it is of polyetiological nature but of identical pathomechanism, the necrosis of the femoral head has been known for more than a century, and, without treatment, it results in complete necrosis. To stop the progression of the process, load-lifting drilling of the affected area was introduced in the 1970s. Since then, the success of the technique in the early stage of the disease has been justified by countless follow-up examinations and studies. Load-lifting drilling of the affected area in the early stage of the disease yielded similar results at our department in a small clinical sample over 6 years. To ensure permanent drainage, we have used cannulated titanium screws with a diameter of 9 mm for the second year now; besides allowing continuous decompression these screws hold mechanically well and the use of titanium allows MR and CT investigations later on.