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.


Osteotomy
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

HIP REPLACEMENT.

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.

HIP RESURFACING.

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.