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Osteonecrosis

Osteonecrosis is a medical condition affecting the knee where the blood supply to the bone is disrupted, which in turn causes the bone cells to die leading to the damage of the hip joint, resulting in its total damage and arthritis.

This is also called Avascular Necrosis or Aseptic Necrosis and it can happen to any bone but it generally affect the hip. The pain in the hip is the first major symptom which might lead to a dull ache or throbbing pain either in the groin or buttock area. The patient will have difficulty in standing, putting weight on the hip and even walking.

Treatment

Non-Surgical Methods

This can help in stopping the progression of the disease and help in reliving the symptoms. The different non-surgical treatment options are:

  • Observing and protected wear-bearing

  • Non-Steroidal Anti-Inflammatory Drugs (NSAIDs): like Ibuprofen etc.,can help reduce the pain and swelling.

  • Physical Therapy: is usually recommended with exercises for restoring movement of the hip and improving the gait.

  • Electrical Stimulation: is useful if it is done before the breakdown of the femoral head.

Surgical Methods

The doctor will recommend either of the surgical options for the treatment.

  • Core Decompression

In this procedure, a large hole or a couple of smaller holes are drilled into the femoral head, to relieve the pressure in the bone and creating channels for newer blood vessels to supply blood to the affected area in the hips.

Core Decompression is most effective if the hip osteonecrosis is diagnosed early before the collapse of the femoral head and arthritis develops. This technique is combined with bone grafting to regenerate the healthy bone and support the cartilage at the joint.

Bone graft, or the healthy bone tissue, is transplanted to the area that requires this. This involves the harvesting an extra bone from one part of the body and then move or graft it to another body part. This is called Autograft. Doctors usually use the bone harvested from a donor or a cadaver.

  • Stem cells – bone marrow aspirate and cancellous bone pegs .

  • Total Hip Replacement

This option usually opted when there is an advanced collapse of the femoral head. This treatment involves the replacement of the damaged cartilage and the bone with artificial implants.

This treatment has proved effective in 90 to 95 percent of the patients, by relieving pain and restoring function.

  • Vascularized Fibula Graft

In this procedure, a bone segment is taken from the fibula or a small bone in the patient’s leg along with the artery and vein and then reattached to the damaged area, thus helping to heal the area affected.

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