Surgical · Hip-Preserving
Core Decompression + BMAC: Hip-Preserving Surgery for AVN
A proven surgical option for Grade 2–3 AVN that relieves pressure inside the bone and adds your body's own healing cells, so your natural hip gets a real chance to recover.
What is core decompression, in simple words?
In AVN, pressure builds up inside the femoral head (the ball of your hip joint) because the blood supply is blocked. This pressure causes pain and starves the bone further.
Core decompression is a surgery where the surgeon drills one or more small channels into the affected bone. This does two things:
- Releases the pressure inside the bone, many patients feel pain relief quickly.
- Opens pathways for new blood vessels to grow into the damaged area.
What is BMAC and why is it added?
BMAC stands for Bone Marrow Aspirate Concentrate. During the same surgery, the doctor draws bone marrow from your own hip bone, concentrates the healing cells in it, and injects them into the drilled channels.
Think of it this way: the drilling opens the door, and the BMAC cells walk in to do the repair work. Studies and clinical experience suggest that adding BMAC improves results compared with drilling alone.
Who is this surgery right for?
| Good candidate | Not suitable |
|---|---|
| AVN Grade 2 or Grade 3 on MRI | Grade 4 AVN with collapsed femoral head |
| Can commit to 6–8 weeks of protected weight bearing | Cannot use a walker/crutches for several weeks |
| Wants a proven hip-preserving surgery | Severe arthritis already present |
Check your grade first on our Stages of AVN page, or send us your MRI for a free review.
Recovery: what to honestly expect
- Hospital stay: usually 1–2 days.
- Weeks 1–8: protected weight bearing with a walker or crutches. This is the most important phase, the drilled bone is healing and must not be overloaded.
- The first 90 days: this is when the risk of bone collapse is highest. Follow your surgeon's instructions strictly.
- Weeks 6–12: gradual return to normal walking, guided by physiotherapy. Learn more about physiotherapy and supportive care.
Risks to be aware of
- Bone collapse during early healing (mainly the first 90 days)
- Infection, rare in certified facilities, but real
- Anesthesia-related risks, as with any surgery
- The bone may still progress to collapse later if AVN was advanced
How does it compare with other options?
Vs SVF therapy: SVF is a same-day injection procedure with no weight-bearing restrictions, best for Grade 1–3A. Core decompression is more invasive but is a long-established surgical technique that some Grade 2–3 cases genuinely need.
Vs hip replacement: Core decompression tries to save your natural joint; replacement swaps it for an artificial one. If your bone has not collapsed, preserving is usually worth attempting first. Read: Hip preservation vs hip replacement.
For the complete picture of all four options, see the Complete AVN Treatment Guide.
Is Core Decompression Right for You?
Send us your details and we will call you back. We review your MRI for free and explain honestly whether core decompression, SVF therapy, or another path fits your case.
- Free MRI report review
- Honest, stage-wise advice
- In-person consultations at certified facilities
We do not provide telemedicine. All medical consultations happen in person at certified facilities.
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Core Decompression: Frequently Asked Questions
Is core decompression a major surgery?
It is a real surgery, but much smaller than hip replacement. The surgeon drills small channels into the femoral head through a small incision. Most patients stay in hospital for 1–2 days. The main commitment is the recovery: 6–8 weeks of protected weight bearing with a walker or crutches.
What is BMAC and why is it added?
BMAC stands for Bone Marrow Aspirate Concentrate. Healing cells are drawn from your own hip bone marrow, concentrated, and injected into the drilled channels. This adds a biological boost that helps the bone rebuild, improving results compared with drilling alone.
Which AVN grades suit core decompression?
It works best for Grade 2 and Grade 3 AVN, before the femoral head has fully collapsed. In Grade 4, the bone shape is already lost and hip replacement is usually the better option. See the stages of AVN.
What are the risks of core decompression?
The main risks are bone collapse during the first 90 days of healing (which is why weight-bearing rules matter), plus the usual surgical risks of infection and anesthesia. Following your surgeon's recovery plan closely greatly reduces these risks.
Core decompression or SVF therapy, which should I choose?
Both aim to save your natural hip. SVF therapy is less invasive with no weight-bearing restrictions; core decompression is a proven surgical option that some cases genuinely need. The right choice depends on your MRI, get a specialist review before deciding.
Considering Surgery? Get a Second Opinion First.
Before you commit to any procedure, let a specialist review your MRI for free. Sometimes a smaller option can save your hip, and sometimes surgery really is the right call. We tell you honestly.
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