How is Avascular Necrosis Treated Conservatively & Surgically?

About Avascular Necrosis:

Avascular Necrosis is a musculoskeletal condition characterized by necrosis of a bone tissue as a result of inadequate blood supply to the bone.1 This results in the bones to break or ultimately collapse. Any individual can be affected with Avascular Necrosis, although this disease is more prevalent in individuals between 30 and 60 years of age. If Avascular Necrosis is diagnosed in a young individual it may lead to long term complications for that individual.

There are various causes for reduced blood supply to the bone leading to Avascular Necrosis.1 Fracture or dislocation of the bone is perhaps the most common cause. In addition, chronic high dose steroid use and alcohol abuse has also been noted to cause reduced supply of blood to the bones resulting in development of Avascular Necrosis.

Some of the other causes of reduced blood supply to the bones causing Avascular Necrosis are bone trauma as a result of a fall or accident which decreases the blood supply to the bones. Accumulation of fatty deposits in the arteries may also lead to decreased supply of blood to the bones resulting in Avascular Necrosis. Certain medical conditions like cancer and sickle cell anemia are also known to cause decreased blood supply to the bones causing Avascular Necrosis.

The question that is frequently asked by patients is about the treatment options that are available for Avascular Necrosis. This article gives a brief overview on some of the conservative and surgical treatment options available for Avascular Necrosis.

How Is Avascular Necrosis Treated Conservatively?

How Is Avascular Necrosis Treated Conservatively?

The treatment for Avascular Necrosis depends on the stage at which the condition is diagnosed. During the early stages of Avascular Necrosis, the symptoms can be effectively managed conservatively by medications and therapy. The patient may be given NSAIDs in the form of Tylenol or ibuprofen for relief of symptoms of pain and inflammation.

Additionally, the patient may be given cholesterol lowering medications and blood thinners to prevent any formation of clots that may affect the blood supply to the affected bone. The patient will be advised complete rest and not to put extra stress on the affected bone so as to allow the bone to heal itself and restore adequate supply of blood.

In some cases where the bones of the hip are affected then the patient may be put on a non-weightbearing status with use of crutch for assistance for a period of several months as a conservative mode of treatment for Avascular Necrosis.

Once the symptoms of Avascular Necrosis have calmed down, the patient will be referred to physical therapy for exercises specific to strengthening of bones and joints and improvement of range of motion. In some cases electrical stimulation may be given for added benefit for relief of symptoms of Avascular Necrosis.

How Is Avascular Necrosis Treated Surgically?

If conservative treatments for Avascular Necrosis are ineffective, then the physician may recommend a surgical way to treat Avascular Necrosis. Some of the surgical procedures done for treatment of Avascular Necrosis are:

Core Decompression: In this surgical procedure, a part of the inner layer of the bone is removed. This helps in reducing the pain felt due to the Avascular Necrosis and the additional space provided by the removed bone aids in development of healthy bones and tissues.

Bone Transplant: In this surgical procedure to treat avascular necrosis, a section of a healthy bone is taken from some other part of the body and is fixed to the affected bone to provide added stability and strengthen the area affected by Avascular Necrosis.

Osteotomy: This is a surgical procedure in which a wedge of a bone is removed from a weightbearing joint to reduce the stress on the damaged bone. This procedure is usually done for those avascular necrosis patients who do not wish to undergo joint replacement procedure.

Joint Replacement: This is a procedure reserved as a last resort to treat Avascular Necrosis. This surgical procedure is done when avascular necrosis is already in the advanced stage and the bone has virtually collapsed. In this procedure, the damaged bone is replaced with metal or ceramic parts to provide symptom relief and treat Avascular Necrosis. Studies have shown that approximately 15% of individuals undergo joint replacements every year due to Avascular Necrosis.

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