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best treatment for avascular necrosis

Avascular Necrosis

Meaning of Avascular Necrosis (AVN):

Avascular Necrosis, also called aseptic necrosis, ischemic necrosis, and osteonecrosis is a condition in which there is a loss of blood flow to bone tissue, which causes the bone to die.

Avascular Necrosis is most common in these part of the body: the hips, knees, shoulders, and ankles. It may also occur at some point in time after cancer treatment that included methotrexate, bisphosphonates, or corticosteroids.

What is the Cause of Avascular Necrosis?

Avascular Necrosis may be caused by long-term use of steroid medicines, joint injuries, alcohol abuse, and certain diseases, such as cancer and arthritis.

  1. Joint or bone trauma: An injury, such as a dislocated joint, might damage nearby blood vessels. Cancer treatments involving radiation also can weaken bone and harm blood vessels.
  2. Alcohol. Several drinks a day can cause fat deposits to form in your blood, which lower the blood supply to your bones.
  3. Bisphosphonates. These medications that boost bone density could lead to osteonecrosis of the jaw. This could be more likely if you’re taking them for multiple myeloma or metastatic breast cancer.
  4. Medical treatments. Radiation therapy for cancer can weaken bones. Other conditions linked to AVN include organ transplants, like kidney transplants.
  5. Certain diseases: Medical conditions, such as sickle cell anemia and Gaucher’s disease, also can cause diminished blood flow to bone.
  6. Steroid drugs. Long-term use of these inflammation-fighting drugs, either by mouth or in a vein, leads to 35% of all cases of nontraumatic Avascular Necrosis. Doctors don’t know why, but longtime use of medications like prednisone can lead to Avascular Necrosis. They think the meds can raise fat levels in your blood, which lowers blood flow.
  7. Blood clots  inflammation , and damage to your  arteries All of these can block blood flow to your bones.
  8. Fatty deposits in blood vessels: The fat (lipids) can block small blood vessels, reducing the blood flow that feeds bones.

Avascular Necrosis Diagnosis

A bone doctor will need to caring out physical examination first. Pressing on your joints to check for tender spots. Then move your joints through a series of positions to check your range of motion. if that is not enough you might get one of these imaging tests to look for what’s causing your pain:

  • MRI and CT scan. These give the doctor detailed images showing early changes in bone that might be a sign of Avascular Necrosis.
  • Bone scan. The doctor injects radioactive material into your vein. It travels to spots where bones are injured or healing and shows up on the image.
  • X-rays. They’ll be normal for early stages of Avascular Necrosis but can show bone changes that appear later on.

Avascular Necrosis Symptoms

Some people develop avascular necrosis on both sides (bilaterally) — such as in both hips or in both knees.

Often times, many people have no symptoms in the early stages of avascular necrosis. As the condition worsens, your affected joint might hurt only when you put weight on it. Eventually, you might feel the pain even when you’re lying down.

Pain can be mild or severe and usually develops gradually. Pain associated with avascular necrosis of the hip might center on the groin, thigh or buttock. Besides the hip, the areas likely to be affected are the shoulder, knee, hand and foot.

Avascular Necrosis Treatment

Many have asked this question; can avascular necrosis be cured?

The best treatment for Avascular Necrosis is to improve the joint, stop the bone damage, and ease pain. And it depends on a number of things, like:

  • Patient’s age
  • Location and amount of bone damage
  • Stage of the disease
  • The actual cause of the avascular necrosis

If you catch avascular necrosis early, treatment may involve taking medications to relieve pain or limiting the use of the affected area. If your hip, knee, or ankle is affected, you may need crutches to take weight off the damaged joint. Your doctor may also recommend range-of-motion exercises to help keep the joint mobile.

  • Medications. If the doctor knows what’s causing your avascular necrosis, treatment will include efforts to manage it. This can include:
    1. Blood thinners. You’ll get these if your AVN is caused by blood clots.
    2. Nonsteroidal anti-inflammatory drugs (NSAIDs). These will help with pain.
    3. Cholesterol drugs. They cut the amount of cholesterol and fat in your blood, which can help prevent the blockages that lead to avascular necrosis.
  • Surgery. While these nonsurgical treatments may slow down the avascular necrosis, most people with the condition eventually need surgery. Surgical options include:
    1. Osteotomy. Cutting the bone and changing its alignment to relieve stress on the bone or joint
    2. Bone grafts. Removing healthy bone from one part of the body and using it to replace the damaged bone
    3. Total joint replacement. Removing the damaged joint and replacing it with a synthetic joint
    4. Electrical stimulation. An electrical current could jump-start new bone growth. Your doctor might use it during surgery or give you a special gadget for it.
    5. Core decompression. Removing part of the inside of the bone to relieve pressure and allow new blood vessels to form
    6. Vascularized bone graft. Using your own tissue to rebuild diseased or damaged hip joints. The surgeon first removes the bone with the poor blood supply from the hip, then replaces it with the blood-vessel-rich bone from another site, such as the fibula, the smaller bone in your lower leg.

Diet for Avascular Necrosis

Eating a well-balanced is important for healthy living. When you have Avascular Necrosis a healthy diet should be a priority in other to get all the necessary nutrients you need, this will help you maintain a healthy weight.

Consider these healthy diet for Avascular Necrosis:

  • High in fruit and vegetables: 4-5 servings per day of fresh vegetables (especially those from the cabbage family) like:
    • Broccoli, brussel sprouts, kale, cauliflower, cabbage and kelp are loaded with antioxidants that detoxify the body of harmful substances.
    • Substitute sweet potatoes for white potatoes;
    • Other good choices are carrots, butternut squash, green leafy vegetables, pumpkin, red and yellow onions, celery and celery seeds.
  • Low in added sugars
  • High in starch and fibre
  • Low in fatty foods and salt


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