Avascular Necrosis (Osteonecrosis) is the premature death of the bone components due to the lack or reduced blood supply to the affected bone . Avascular necrosis (AVN) of the hip is a condititon in which the bone in the femoral head is destructed and collapsed due to reduced blood supply to the region. This also results in the wear down of the articular cartilages that covers the hip joints ,with the end result of total destruction of the hip joints. As a result of this bone destruction chronic pain persists and the functionality of the bone is lost. Avascular necrosis (AVN) is also known by different names such as aseptic necrosis, or ischemic bone necrosis or osteonecrosis.
What can be the causes of Avascular necrosis of hip?
A number of reasons are known to interrupt the blood flow to the bone, some of which are the long term usage of steroids or drugs, hip dislocation or fracture of the hip bones particularly joints, and excessive alcohol consumption. People suffering from osteoarthritis, rheumatoid arthitis, osteoporosis, sickle cell anemia, HIV, and gout are also prone to osteonecrosis of the hip. Decompression sickness , gaucher’s disease and hypertension are the other known causes leading to aseptic necrosis.
What are symptoms associated with Avascular necrosis of hip?
Usually people suffering from avascular necrosis exhibit no symptoms in the early stages . As the disease progresess , the patients develop hip pain .Eventually as the disease worsens,the patients experiences pain in groin and buttock area , and activities like walking intensify the pain.They find it difficult to move the affected part of the joint, and experience pain even when the body is at rest. Disease progression is usually slow, it might take several months.
How to diagnose Avascular necrosis of hip?
A number of diseases are associated with joint pains such as rhematoid arthitis, so it is important to diagnose the actual cause of the pain associated with joints. The best suited diagnostic test is MRI, as it can detect the avascular necrosis in the early stages even when no symptoms are exhibited. X-rays and bone scans are also utilized for this purpose , but early stage detection is not possible with these tests, however as the disease progressess, these tests can be employed for the diagnosis. CT scan are also used to determine the extent of the bone damage. Bone biopsy can also be performed at late stages,but are not done commonly.
How to treat Avascular necrosis of hip ?
Different factors are considered before deciding the treatment . Some of them are the patients age , location of the bone damage , the stage whether early or late, and various conditions that lead to avascular necrosis.These is no specific treatment for osteonecrosis , but the symptoms exhibited by the patient can be managed by medications . The pain can be
reduced using different medications , physical therapy or by lifestyle changes. Weight management is another option which helps to reduce stress on the joints, for this crutches can be used. In some cases, a procedure of Core decompression can be done. This procedure allows increased blood supply to the femoral head and so that the affected areas of the hip are nourished.In advanced stages of AVN the doctors suggest total hip replacement surgery to restore movement and relieve pain.