Avascular necrosis of the femoral head, causing pain in the hip joint

Femoral head avascular necrosis (AVN) can cause pain in the hip joint. It is defined as the death of the head femoral suite partial or complete the annihilation of its blood supply.

It can be classified into two categories

1.Primary or idiopathic: in which no cause can be established.

2.Secondary: due to an underlying cause which may include alcohol steroid abuseinjectable useradiation therapyGouchers diseaseCaisson diseaseGoutrenal osteodystrophysickle cell anemia

Primary disease is more frequent in men aged 40 to 60 years. Up to 60% of cases, both hips may be involved.

Diagnosis can be established from the following surveys

Analysisof magnetic resonance (MRI) imaging of the hip joints. This is the investigation of choice as it can detect necrotic bone even where other research fail.Tomography of two hips. It shows the density of the radio.Isotope analysis will show a decrease in uptake of isotope in hip affected in the early stages (no present symptoms).

Prognosis of avascular necrosis of femoral head is poor. Eventually almost all patients develop subchondral collapse, that the progression of osteoarthritis is inevitable.

This means that the bone dead in the head of the femur becomes low and fails. This causes the articulation of the hip to become incongruous. This causes osteoarthritis of the hip.

This x-ray shows necrosis in both counts femur after use of steroids. On the left side collapse occurred and subsequent arthritis has developed. On the head there is no collapse.

Until now, there is no effective treatment to slow the progression of osteoarthritis. Once that OA has defined methods of treatment of hip osteoarthritis are used.

Many operations are described in the literature for avascular necrosis of the hip. Most of them now have only historical importance. They include

1 Core decompression.

2 Decompression with bone graft base.

3. Vascularized fibular grafting.

4 Intertrochanteric osteotomies.

I personally do not use any of the above. Manage patient analgesics and walk (crutches) as much as possible. When the pain becomes unbearable, or patient wants that freedom of analgesics and AIDS Walk, I perform a total knee replacement.

Total knee replacement is the only permanent cure for hip osteoarthritis, which is the ultimate goal of avascular necrosis.

How long does for the femoral head to collapse after necrosis?

It varies from one patient to no criteria have been developed to predict. Can vary from a few months to more than 5 years.

Is the use of crutches to walk or bed rest to avoid the collapse?

These methods have been proven to be ineffective.

To the surface of hip (ASR) AVN?

Yes, it can, but only after that subsequent x-ray showed no progress of the collapse of the femoral head.

The dead bone can undergo revascularization (develop vessels blood and is replaced by live bone and in good health)?

Yes, it can, but this is rare.

I hope that the information provided was useful. If you have any query you can ask me to contact me page.

This page was last updated March 2, 2009.

Other common causes of hip pain...

Hip osteoarthritis

Hip Fracture

Perthes disease

Congenital dislocation of hip

Hip replacement

Hip Anatomy

Return of avascular necrosis of the hip pain

View the original article here