Avascular Necrosis (AVN) of the Hip Treatment in San antonio

What is AVN of the hip?

Also known as osteonecrosis, avascular necrosis (AVN) of the hip can be a source of significant hip pain. This condition disrupts blood flow to the hip joint, leading to bone death and potentially leading to joint collapse. While AVN is serious, early diagnosis and treatment from San Antonio Orthopaedic Specialists' experienced team can help preserve your hip joint and prevent further complications.

AVN of the hip is a debilitating condition that affects the blood supply to the femoral head, the ball-shaped top of your thigh bone that fits into the hip socket. When blood flow is disrupted, bone tissue in the femoral head dies. Without a steady supply of blood, the bone weakens and eventually collapses, leading to pain and limited movement in the hip joint.

Symptoms of Avascular necrosis of the hip

Avascular necrosis (AVN) of the hip can be a sneaky condition. In its early stages, you might experience no symptoms at all. However, as the bone tissue in the femoral head weakens and the joint begins to deteriorate, some telltale signs can emerge. Here's what to watch out for:

  • Hip Pain: This is the most common symptom of AVN. The pain may initially be dull or achy, located deep in the groin, buttock, or thigh. It can worsen with activities that put weight on the hip, such as walking, standing for long periods, or climbing stairs.

  • Pain Worsening with Activity: As AVN progresses, the pain often intensifies with activity and may even become noticeable at rest.

  • Limited Range of Hip Motion: Stiffness in the hip joint can develop, making it difficult to bend, extend, or rotate your hip. This can limit your ability to perform everyday activities.

  • Pain Radiating Down the Leg: In some cases, the pain associated with AVN can radiate down the leg, toward the knee.

Don't ignore these symptoms! While they can be caused by other hip problems, if you're experiencing any of them, particularly persistent hip pain that worsens with activity, it's crucial to consult a doctor for a proper diagnosis. Early detection of AVN allows for prompt treatment and helps prevent further damage to the hip joint.

Avascular Necrosis (AVN) of the Hip, treatment by San Antonio Orthopaedic Specialists

Causes of avascular necrosis

non-traumatic causes:

  • Corticosteroid Use: Long-term use of high-dose corticosteroids, medications often prescribed for conditions like asthma or lupus, can increase the risk of AVN. The exact mechanism is not fully understood, but corticosteroids may contribute to fat deposits in blood vessels or suppress blood cell production, impairing blood flow.

  • Excessive Alcohol Use: Chronic heavy alcohol consumption can damage bone tissue and disrupt blood flow, increasing the risk of AVN.

  • Medical Conditions: Certain medical conditions can raise your risk of AVN, such as:

    • Sickle cell disease: This blood disorder can cause abnormal blood clotting, potentially leading to blocked blood vessels in the hip.

    • Gaucher disease: A rare genetic disorder that affects fat storage in the body, including the bones. The buildup of fatty substances can disrupt blood flow.

    • Systemic lupus erythematosus (SLE): This autoimmune disease can damage blood vessels, including those supplying the hip joint.

  • Other Risk Factors: Additional factors that may be linked to AVN include decompression sickness (from rapid ascent during diving), radiation therapy, and certain medications besides corticosteroids.

Traumatic Causes:

  • Hip Fractures or Dislocations: Injuries that damage the blood vessels around the hip joint can disrupt blood flow to the femoral head.

  • Surgery: In rare cases, surgery around the hip joint can inadvertently damage blood vessels, leading to AVN.

It's important to note that not everyone exposed to these risk factors will develop AVN. Some individuals may be more predisposed to the condition for reasons yet to be fully understood.

If you have any concerns about your risk factors for AVN, it's important to schedule a consultation with a specialist as soon as possible. They can help you understand your individual risk and recommend preventive measures if necessary.

Surgical SOlutions & Treatments:

When AVN is more advanced and the bone has started to collapse, surgery may be necessary to preserve the hip joint and restore function. Surgical options can include:

  • Hip Replacement: If the femoral head has already collapsed significantly, a total hip replacement may be the best option. This surgery involves removing the damaged hip joint and replacing it with artificial components. Modern hip replacements are durable and can restore pain-free movement and function for many years.

  • Core Decompression: This tissue-sparing procedure involves drilling a core hole in the femoral head to create a passage for new blood vessels to grow into the bone. This can help stimulate bone healing and delay the need for joint replacement.

  • Bone Grafting: In some cases, core decompression may be combined with bone grafting. Surgeons take healthy bone tissue from another part of the body and transplant it into the affected area of the femoral head to promote bone growth and support the joint.

treatment options for Avascular Necrosis of the hip

The most effective treatment for AVN of the hip depends on several factors, including the severity of the condition, the stage of bone damage, and your overall health. Here's an overview of the treatment options available:

Non-Surgical Treatments:

  • Rest and Activity Modification: In the early stages of AVN, reducing weight-bearing activities on the affected hip can help limit further damage. This may involve using crutches or a cane for support and avoiding activities that aggravate your pain.

  • Physical Therapy: Strengthening exercises for the muscles around the hip joint can improve your stability and range of motion while reducing pain and stiffness.

  • Pain Medication: Over-the-counter pain relievers like ibuprofen or acetaminophen can help manage pain and inflammation. In some cases, your doctor may prescribe stronger pain medication. Learn about the non-opioid pain relief medication, iovera!

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    Adam I. Harris, MD

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