Functional Outcomes for Children, Adolescents, and Young Adults With Osteonecrosis Following Hip Core Decompression

Abstract

Background: Patients with pediatric leukemia and sickle cell disease are at risk for developing osteonecrosis (ON), a disease that can result in pain, loss of function, and disability. Hip core decompression surgery is an option aimed to prevent femoral head collapse and avoid future arthroplasty. Objective: Describe functional outcomes and gait quality among a young population with hip ON before and after hip core decompression. Methods: Study included participants with hip ON secondary to treatment for hematologic malignancy or sickle cell disease, between 8 and 29 years of age, requiring hip core decompression surgery. At 1-year follow-up, 13 participants (9 male, median age of 17 years) completed the Functional Mobility Assessment (FMA), range of motion, and GAITRite testing. Results: The participants demonstrated improved mobility and endurance on the FMA at 1 year postoperatively compared with preoperatively, with higher scores for time on the Timed Up and Go (mean FMA score = 2.92 [SD = 1.32] vs 2.07 [SD = 1.70]), time on the Timed Up and Down Stairs (3.69 [0.85] vs 2.92 [1.66]), and 9-Minute Walk Test scores for distance walked (2.69 [0.63] vs 2.23 [0.93]) and heart rate (4.54 [0.66] vs 3.31 [1.38]). GAITRite analysis also showed improvements in many gait parameters at 1-year follow-up. Limitations: Cancer treatment complications other than ON could have contributed to results, not all eligible participants agreed to participate, and follow-up was only 1 year. Conclusions: Young patients with hip ON demonstrated improvements in functional mobility, endurance, and gait quality 1 year following hip core decompression.