Tuesday, February 2, 2010

Avascular Necrosis & Hip-Resurfacing.

I tried to put off surgery for my bilateral necrosis for almost 18 months and tried alternate therapies. Now as things have only gone from bad to worse and I will be going in for surgery.

I have found out that there are two types of surgeries that one can get. A hip replacement and hip resurfacing. The hip replacement is a time tested technology which most surgeons are comfortable with performing. Moreover as it a relatively old technology we have clear numbers and case studies showing us its success rate.
I have a friend who is an orthopedic surgeon and he too highly recommends the metal on metal total hip replacement as its tried and tested and proven to be successful and last for roughly twenty years at least.

There is a new kind of implant for younger and more active patients. The new hip resurfacing promises better results in terms of longevity as well as range of activity possible after surgery.
Also i have come to learn that for any reason if hip resurfacing does not give desired results or is the surgery is not a success it can be easily converted to a total hip replacement.
The amount of bone cut out during the hip resurfacing is very little compared to that of a total hip replacement.
The only drawback being the fact that this being a relatively new technique we don't have long term clinical results. However the current data available is very promising and it certainly looks to be more beneficial than the total hip replacement.

Anyway I will be meeting a hip resurfacing specialist Dr Vijay Bose at Apollo hospital in Chennai to discuss my options. He is said to be the pioneer in this kind of surgery in India.

This is a general forum where hip resurfacing patients discuss about their surgery and its outcome.

This website is a rather disturbing but surprisingly informative.

Corin and smith&nephew are the good people who make the implants used for hip resurfacing. you can go to their website and ask for more information and the mail it to you.

Monday, February 1, 2010


In India we have a god for every occasion, i believe the official number is 330 million. However some are a little more important than others.It depends on how impressive a legends you have to back you up.

Now according to legend the good people (Devas) and the not so good evil people (Asuras) were churning the ocean for Amrita, the immortality potion. now out of the ocean comes a man bearing a pot of Amrita- Lord Dhanvantri. It is believed that he is the healer of all diseases and ailments. God of Ayurveda.

Ayurveda has its origins in the Vedas, Atharvaveda in particular. The Sushruta Samhita of Sushruta dating back to sometime in the 1st millennium BC forms the very basis of Ayurveda.

Ayurveda is known to be able to treat a wide range of diseases that western medicine is yet struggling with. Most ayurvedic treatment is very relaxing and rejuvenating. The Panchakarma treatment is said to be able to cleanse your complete system of all toxins.

Ayurveda is a complex science and needs immense dedicated study to be precised. Now in most places it is reduced to just a luxury spa. There are few places where Ayurveda is practiced in the true holistic form.

Arya Vaidya pharmacy
(Coimbatore) is one such Ayurvedic hospital where one can expect to and receive pure holistic Ayurvedic treatment for almost any medical disorder and also unwind in a perfect setting of a healing home of true Indian values culture and traditions.

Sunday, January 31, 2010

Ayurvedic treatment for Avascular Necrosis

The thing with alternative therapies is that the doctors will never NO. They are never going to say "i have no idea whats wrong with you."So you have to be very careful which doctor you pick.
Now in my attempt to avoid surgery for avascular necrosis i have tried many many therapies and many many doctors. Most naturopaths I'm sure dint understand what avascular necrosis was all about.

Anyway in my experience of dietitians, homeopaths, acupressure, acupuncture, Ayurveda and others i have found Ayurveda to be most beneficial.

If anyone out there is looking for an alternative to surgery in treating avascular necrosis avp is the place. I have taken treatment under Dr KG Ravindran and Dr Narayanan at Arya Vaidya Pharmacy (Coimbatore). Dr Ravindran has treated a patient of avascular necrosis with favorable results. In any case I'm sure he fully understands what avascular necrosis is all about.

Now the treatment itself is very relaxing if not anything else. The treatment includes a daily massage and some herbal concoctions. You have to stay there at least for twenty one days, eat their food and be at their mercy.
It is not as bad as it sounds. (they provide hi speed Internet connections)

If your avascular necrosis is as a result of alcohol abuse or external injury i hear it is much easier to treat. Even if you have got surgery for avascular necrosis  (or anything else) there are therapies you can take to to help with the healing process and pain and so on.

In my opinion if you have a shot at treating avascular necrosis without surgery it is at AVP Coimbatore.

You can e-mail the doctors your reports and ask them for their opinions here.

The Dietitian the Homeopath the Astrologer

I was diagnosed with bilateral avascular necrosis of the femoral heads about 18 months back.
I developed the necrosis as a side effect of steroid use.

My orthopedic doctors suggested core decompression (surgery) as the necrosis was between stage 1-2 also there was no certainty that the operation would be a success so i found good reason in not jumping into surgery just yet.

First up was Vijaya Venkat. A renowned dietitian in Mumbai. They are a daughter and mother duo who claim that the body has the ability to heal itself. All you need to do is give it what it needs in order to do the healing. They put you on a diet which is mostly made up of raw vegetables, vegetable juices, fruit juices some pulses and a whole lot of lime.
I was on this diet for a little more than a month and necrosis dint get any better.

Next up was a homeopath. A scientist by day and doctor by evening. Doctor Sukumaran also from Mumbai. His home clinic was filled with people waiting for their turn with the scientist doctor. I has to wait in the stairway leading to his house. At this point i realized either he is really good or he charges very little. He dint seem to think avascular necrosis was a big problem what so ever, "fifteen days, in just fifteen days you will feel better and call me up to say i am fine" that's what he said after taking a look at me and reports. I took his word for it and kept popping little sugar ball all through the day. i went on with this treatment for 2 months.
The only thing i got from the sugar balls was extreme acidity.

Now is when i should have gone back to my orthopedic surgeon and let him do his thing, but nooo.


YES and so we did.

Thursday, January 28, 2010

Avascular Necrosis

If you or someone you know is a avascular necrosis (avn) patient these are the three questions that need immediate answering.

what is avascular necrosis?

A Google search will bring up hundreds of pages but in simple words necrosis is degeneration and/or dying of bone tissue dude to temporary or permanent loss in blood supply to that part of the bone.It mostly occurs in the hip joints.

now avascular necrosis comes with its fair share of pain, lack of mobility, and uncertainty.
pain management is an important aspect of dealing with the disease.

What is avascular necrosis caused by?

Avascular necrosis of the bone is a complication of corticosteroid use, trauma, systemic lupus erythematosus, pancreatitis, alcoholism, gout, and sickle cell disease, as well as other diseases.

What are the treatment options for avascular necrosis of the hip?

Treatment depends on the intensity of the disease. Some stages can be controlled with rest and medications and some are not.

There are surgical and non-surgical options.

Non-surgical treatment options for avascular necrosis (avn).

In the initial stages of avascular necrosis (stage one-two) where the x-ray, mri show that the bone structure is maintained non-surgical options can be explored.

Ayurveda is one of the best non-surgical options available in treating avascular necrosis. the outcome varies from patient to patient.

Homeopathy is another option which can help in controlling the progression of the disease.

Chinese herbal medication. Now there are tons of these available all over the internet. however the authenticity of each must be checked before hand.

While Ayurveda, Homeopathy and Chinese herbs are the main alternatives for treating early stage of avascular necrosis there are several other options that can be explored like acupuncture, acupressure, diet etc. There are many others which are under research and yet to be proven useful.

Surgical options for treating avascular necrosis of the femur (hip).

There are various options depending on the intensity of the necrosis.

Core Decompression
This procedure removes the inner layer of bone, which reduces pressure within the bone, increases blood flow to the bone, and allows more blood vessels to form. It works best in people who are in the earliest stages of AVN, often before the collapse of the joint. This procedure sometimes can reduce pain and slow the progression of bone and joint destruction in these patients.

This procedure reshapes the bone to reduce stress on the affected area. Recovery is lengthy and the patient's activities are very limited for 3 to 12 months. This procedure is most effective for patients with advanced AVN and those with a large area of affected bone.

Bone Graft
A bone graft may be used to support a joint after core decompression. Bone grafting is surgery that transplants healthy bone from one part of the patient, such as the leg, to the diseased area. Commonly, grafts (called vascular grafts) that include an artery and veins are used to increase the blood supply to the affected area. There is a lengthy recovery period after a bone graft, usually from 6 to 12 months. This procedure is complex and its effectiveness is not yet proven.

The only other options remaining are joint replacements.

There are two major types of joint replacements

-hip replacement
-hip resurfacing


There are different types of hip replacements, the doctor can better choose which may suit you best.
the implants are said to last for about twenty years.


This is relatively new procedure and is expected to last longer than the conventional hip replacement.

The above are my observations as a patient of (bilateral) avascular necrosis of the femur. This should not be mistaken for a doctors opinion.