Question about Avascular necrosisMy friends 17 year old son has been diagnosed with Avascular Necrosis in September 2016. He is on crutches and receiving pain relief and hydrotherapy. His mother is getting increasingly frustrated and worried that not enough is being done. what next? Any advice gratefully received.
Well it's very difficult to say what to do without seeing him, but if you want more information, then you need to speak to the treating Orthopaedic Surgeon. You are entitled to a second opinion if you are not happy with this.
In broad terms, early disease can be treated expectantly unless pain is bad. There is a procedure called core decompression, which can be coupled with a grafting procedure to reduce pain and hopefully improve the return of the blood supply to the affected femoral head. However, this can only be done before the surface of the joint has undergone permanent change on X-ray. If it is already altered, core decompression is not indicated. Unfortunately after this stage, most people with severe symptoms are managed with injections, physiotherapy and pain killers, but a significant proportion end up needing an early hip replacement.
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