Dr. Joel Williams offers advanced cartilage restoration techniques and treatments for avascular necrosis (AVN) of the hip for patients in Chicago, and nationwide. These hip preservation strategies aim to treat early‐stage joint damage, delay degeneration, and potentially avoid or postpone hip replacement for the right candidates.
The hip is a ball-and-socket joint: the femoral head (ball) articulates with the acetabulum (socket). Damage to cartilage, or disruption of blood supply to the bone (as in AVN), can lead to pain, dysfunction, collapse of the femoral head, and osteoarthritis. In carefully selected patients, cartilage repair, grafting, and decompression techniques can help restore joint health and structural integrity.
If the damage is too extensive or the femoral head is already collapsed, sometimes a hip replacement is the more reliable option.
Avascular Necrosis (AVN) - also called osteonecrosis - occurs when the blood supply to a region of bone (commonly the femoral head) is disrupted, causing bone tissue to die and eventually collapse if left untreated. In the hip, AVN often leads to progressive joint damage and pain that worsens over months to years.
Meanwhile, cartilage damage often occurs from trauma, impingement, or degenerative joint stresses. Unlike bone, cartilage does not heal easily on its own. That’s where cartilage restoration techniques can be employed: such as grafting, microfracture, osteochondral transplantation, or using donor cartilage to repair localized lesions.
If AVN is caught early (before collapse of the femoral head), core decompression is a key tool. In this procedure, a surgeon drills into the necrotic zone to relieve intraosseous pressure, stimulate new blood vessel growth, and promote healing. Bone grafts (autograft or allograft) or biologic agents may be packed into the tract to support structural integrity.Dr. Williams typically performs a core decompression with arthroscopic assistance or in a minimally invasive fashion. Many times, Dr. Williams also combines decompression with stem cell therapy or growth factors to enhance regeneration.
For focal, well-circumscribed cartilage or bone lesions, Dr. Williams may perform a surgical hip dislocation to fully visualize the femoral head and socket. This approach allows precise transplantation of donor cartilage or bone, repair of the labrum, and reshaping of any impingement lesions - for a more comprehensive preservation surgery.
In this approach, grafts of bone and cartilage may be used to fill localized defects. The technique requires careful planning, a hospital stay (often 1–2 nights), and a detailed postoperative recovery plan.
Patients diagnosed early, before collapse of the femoral head.
Those with localized cartilage lesions or focal AVN, not widespread joint degeneration.
Individuals with good bone quality and limited structural deformity.
Patients willing to commit to the recovery process, which may include restricted weight bearing, physical therapy, and close follow-up.
Younger or active patients who wish to preserve their natural joint and delay - or perhaps avoid hip replacement.
Procedures like core decompression, cartilage grafting, or surgical hip dislocation are done under general or spinal anesthesia. Fluoroscopic navigation (x-rays during surgery) is used to ensure precision. When hip dislocation is used, osteotomies may be done to safely dislocate the hip and allow complete access to the joint.
Patients typically stay in hospital 1–2 nights for monitoring and early pain control, and may start limited physical therapy.
Use of crutches or restricted weight bearing (often for 6–12 weeks) to protect grafts and allow healing.
Gradual progression in physical therapy to restore motion, strength, and joint mechanics.
Monitoring via imaging to assess healing and graft incorporation.
Return to light daily activities by ~3 months, with higher-demand activities possibly delayed up to 6-12+ months depending on graft size, patient healing, and goals.
The objective is to preserve the joint, delay degenerative changes, stabilize the femoral head, and maintain function for years.
Infection, bleeding, or blood clot (DVT)
Graft failure, nonunion, or collapse of the femoral head
Donor graft rejection or poor incorporation
Persistent pain or mechanical symptoms
Need for future surgery, including hip replacement
Nerve irritation or soft tissue issues
Rehabilitation may be prolonged, and full recovery timelines vary
Dr. Williams discusses each of these in detail during patient consultations to ensure realistic expectations and careful planning.
Board-certified hip surgeon with specialized training in hip preservation, cartilage restoration, and AVN treatment
Experienced in both minimally invasive and open techniques to tailor to patient anatomy
Integrated rehabilitation team in Chicago, offering continuous support during recovery
Serves patients from Chicago, Oak Brook, Naperville, Oak Park, and from all over the country.
Focused on achieving long-term outcomes, preserving native joint function, and avoiding or delaying hip replacement when possible
If you’re suffering from symptoms of hip pain, cartilage injury, or early AVN in Chicago or nearby areas, schedule a consultation with Dr. Williams. He will review your imaging, evaluate if cartilage restoration or decompression is feasible, and help you map out the best path toward preserving your hip and regaining mobility.
If your doctor suggests hip treatment, seek a second opinion and explore the best option.
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