Avascular necrosis, also known as osteonecrosis, is a condition characterized by bone death due to inadequate blood supply. Insufficient blood flow may result from bone fractures or joint dislocations that damage nearby blood vessels. Chronic use of high doses of steroid medications and heavy alcohol consumption are the primary risk factors for avascular necrosis. Initially, small fractures may appear in the bone, eventually leading to collapse. While the hip joint is most commonly affected, the knee and shoulder may also be impacted.
Symptoms of avascular necrosis may suddenly manifest following an injury, while in other cases, pain and stiffness may gradually develop over time. Typically, avascular necrosis causes pain and limits the range of motion in the affected joint. Diagnosis involves imaging tests such as X-rays, MRI scans, and bone scans, which help rule out other causes of joint pain.
Treatment for avascular necrosis aims to prevent further bone loss and depends on the extent of existing bone damage. Conservative treatment methods may reverse early stages of avascular necrosis, while surgical intervention may be necessary in more advanced cases.
Conservative Approaches:
- Medications: Non-steroidal anti-inflammatory drugs (NSAIDs) may be prescribed to manage pain and swelling.
- Rest: Limiting physical activities and using crutches to reduce weight bearing on the joints can be beneficial.
- Exercises: Regular exercises that improve range of motion may be recommended.
- Electrical Stimulation: Electric currents promote new bone growth and can be applied directly to the damaged area or through electrodes placed on the skin, aiding in bone regeneration.
Surgical Treatments:
- Core Decompression: In this procedure, a portion of the inner bone layer is removed to alleviate pressure within the bone, reducing pain and stimulating new blood vessel and bone growth.
- Bone Transplant: Healthy bone harvested from another part of the body is grafted into the affected area.
- Bone Reshaping (Osteotomy): Reserved for advanced stages, bone reshaping aims to reduce stress on the affected bone.
- Joint Replacement: Joint replacement surgery is considered a last resort when the bone has collapsed, necessitating artificial replacement.