Avascular necrosis - Information, specialists, frequent questions.

Experts in avascular necrosis

Fahad Attar

Fahad Attar

Orthopaedist, Orthopaedic surgeon

Cheadle

Ronan Banim

Ronan Banim

Orthopaedic surgeon

Chester

Arjuna Imbuldeniya

Arjuna Imbuldeniya

Orthopaedic surgeon

Isleworth

Rik Kundra

Rik Kundra

Orthopaedic surgeon

Sutton Coldfield

Jonathan Charles Luscombe

Jonathan Charles Luscombe

Orthopaedic surgeon

Droitwich

Matthew Oakley MB CHB, FRCS, FRCS

Matthew Oakley MB CHB, FRCS, FRCS

Orthopaedic surgeon

Hereford

Questions about Avascular necrosis

Our experts have answered 4 questions about Avascular necrosis

My friends 17 year old son has...

My 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.

 Gaurav Batra
Gaurav Batra Orthopaedist Salford
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.
1 answers
Is avascular necrosis of the hips...

Is avascular necrosis of the hips the same disease as infarct in the knee?

 Gaurav Batra
Gaurav Batra Orthopaedist Salford
Basically, yes. The blood supply to that area of bone has been interrupted (avascular) and the cells which line the structure of the bone die off (necrosis) as a result. However the bone matrix or scaffold remains and so nearby cells can come back to the area as the bone blood supply recovers (usually incompletely). If the blood supply doesn't recover quickly enough, the scaffold can collapse and this leads to loss of joint surface shape and this results in arthritis. The scaffold collapses because it doesn't have the bone cells to keep the bone structure in good repair (to cope with the daily damage which occurs).
2 answers
I have avn in multiple joints,...

I have avn in multiple joints, areas within my femur & tibia caused by steriod treatment for leukaemia 19 years ago. Ive had both hips replaced & need major knee surgery soon. After removal of dead bone & joint replacement, can avn come back in remaining healthy bone?

 Gaurav Batra
Gaurav Batra Orthopaedist Salford
AVN tends to occur because the blood supply to that part of the bone is from an end artery. This means that it is the only blood supply to that part of the bone and so is susceptible AVN as a result. Once the dead bone has been cut out for the purposes of arthroplasty, it usually leaves behind bone which has a much better blood supply so recurrence is very unusual.
1 answers

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