Avascular necrosis (AVN) of the femoral head is a pathologic process that results from the interruption of blood supply to the bone. Compromised femoral head blood circulation leads to ischemia which in turn results in the death of marrow and osteocytes and collapse of the necrotic segment. As a result, the articular cartilage covering the hip bones also collapses, leading to disabling hip arthritis.
The common risk factors include,
More common in people between the ages of 40 and 65. Men develop AVN of the hip more often than women.
The common symptoms include,
There are four stages of AVN. The disease can progress from stage I with mild pain in the groin to stage IV with severe pain and limp while walking.
The most successful treatment options are surgical. Patients with AVN diagnosed in the early stages (before the Femoral Head collapses) are potential candidates for hip-preserving procedures.
Initial stages respond well to Tab Alendronate 70 mg once a week and anti-inflammatory medications.
Restricted weight bearing walking using crutches
Core decompression involves drilling one larger hole or several smaller holes into the Femoral Head to relieve pressure in the bone and create channels for new blood vessels to nourish the affected areas of the hip.
Core Decompression is successful in preventing collapse of the Femoral Head and the development of arthritis when it’s done in early stages (stage I and II).
Core decompression is done with one larger hole into the Femoral Head and the hole is filled with the bone graft harvested from fibula (in the leg) or synthetic bone grafts.
When there is collapse of Femoral Head and arthritic hip joint associated with severe pain and painful movements with restricted activities. Total hip replacement would be the best option.
Usually done under spinal anaesthesia. Surgeon makes one small key hole in the lateral part of hip. Under image control (C-arm) one drill hole was made into the Femoral Head necrotic area. The bone graft is introduced into the hole.
This involves growing patients own bone forming cells (Osteoblasts) from his own blood helping to heel the necrotic dead bone in the AVN of femoral head.
Step 1: A small quantity (4ml) of your blood is taken from bone marrow
Step 2: Blood transported to the certified lab
Step 3: Isolation and culture of Osteoblast cells in the lab
Step 4: Expansion of cultured osteoblast cells for 4 to 6 weeks in the lab
Step 5: Implantation of cultured osteoblastic cells in the damaged Femoral Head to form the new bone.
Many Core Decompression surgeries are done on day-care basis and do not require you to stay overnight in the hospital.
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