Hip AVN (Ostenecrosis)
A loss of blood supply to the hip bone that may lead to joint pain, collapse, and reduced mobility.
Avascular necrosis (AVN), also known as osteonecrosis, is a condition that occurs when the blood supply to a bone is temporarily or permanently disrupted. Without adequate blood flow, the bone tissue dies, leading to the collapse of the bone structure. When AVN affects a bone near a joint, it can cause the joint surface to collapse, resulting in severe pain and limited mobility. While AVN can occur in any bone, it most commonly affects the ends of long bones, particularly in the hip. This condition can impact a single bone, multiple bones simultaneously, or different bones at various times.
SYMPTOMS OF OSTEONECROSIS/AVASCULAR NECROSIS
Common symptoms of AVN of the hip include:
- Persistent pain in the hip or groin, which may radiate to the thigh or buttock
- Increased pain with weight-bearing activities and movement
- Stiffness in the hip joint
- Reduced range of motion
- A limp or difficulty walking
CAUSES OF OSTEONECROSIS/AVASCULAR NECROSIS
Several factors can contribute to the development of AVN, including:
- Trauma: A hip fracture or dislocation can damage blood vessels, leading to reduced blood flow to the femoral head.
- Chronic Use of Steroids: Long-term use of corticosteroids is a significant risk factor, as these medications can interfere with blood flow to the bone.
- Excessive Alcohol Consumption: Heavy drinking can lead to fatty deposits in blood vessels, which can obstruct blood flow.
- Medical Conditions: Certain conditions, such as sickle cell disease, lupus, and blood clotting disorders, can increase the risk of AVN.
- Radiation Therapy: Treatment for cancer can weaken bones and affect blood supply.
DIAGNOSIS OF OSTEONECROSIS/AVASCULAR NECROSIS
Early diagnosis of AVN is essential for effective treatment. Dr Martin uses a comprehensive approach to diagnose AVN, which includes:
- Medical History: A thorough review of your medical history to identify risk factors such as trauma, medication use, and lifestyle habits.
- Symptom Review: Detailed discussion about your symptoms, including the onset, location, and severity of pain, as well as any changes in mobility or function.
- Physical Examination: Examination of the hip for signs of tenderness, stiffness, and reduced range of motion.
- X-Rays: To detect changes in bone structure and identify areas of bone collapse.
- MRI (Magnetic Resonance Imaging): Highly sensitive in detecting early stages of AVN by visualising blood flow and bone tissue health.
- CT Scan (Computed Tomography): Provides detailed cross-sectional images of the hip to assess the extent of bone damage.
- Bone Scan: May be used to evaluate bone activity and detect areas of reduced blood flow.
TREATMENT OPTIONS FOR OSTEONECROSIS/AVASCULAR NECROSIS
The treatment of AVN focuses on relieving pain, improving hip function, and preventing further bone damage. The choice of treatment depends on the stage of the disease and the severity of symptoms.
Non-Surgical Treatments:
- Medications: Pain relievers, anti-inflammatory drugs, and medications to promote bone health.
- Activity Modification: Reducing weight-bearing activities to alleviate stress on the hip joint.
- Physiotherapy: Exercises to maintain joint function and strengthen surrounding muscles.
Surgical Treatments:
- Core Decompression: A procedure to remove a portion of the inner bone to reduce pressure and improve blood flow to the femoral head.
- Bone Grafting: Transplanting healthy bone tissue to support the damaged area and stimulate bone regeneration.
- Osteotomy: Realigning the bone to reduce stress on the affected area.
- Total Hip Replacement: Replacing the damaged hip joint with an artificial implant, typically considered in advanced stages of AVN with significant joint collapse.
PREVENTING OSTEONECROSIS/AVASCULAR NECROSIS
While not all cases of AVN can be prevented, certain measures can reduce the risk:
- Limit Alcohol Consumption: Reducing alcohol intake can help maintain healthy blood flow to bones.
- Use Steroids Responsibly: Follow medical advice when using corticosteroids and explore alternative treatments when possible.
- Manage Medical Conditions: Proper management of underlying conditions like sickle cell disease or lupus can reduce the risk of AVN.
- Avoid Joint Trauma: Protect your hips from injuries and seek prompt treatment for any hip-related trauma.
