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Avascular Necrosis

Avascular means blood flow loss and necrosis indicate cell death or tissue death. When a bone dies because of a lack of blood supply, avascular necrosis or osteonecrosis is identified. Often known are the following names – aseptic necrosis, bone ischemic necrosis, and bone infarction. This disease is very common in persons of age between 30 and 60 years. Sometimes it also affects the children, commonly those who are on cancer therapy. AVN can affect the hip, shoulder, wrist, ankle, etc. Femoral head of hip joint most commonly affected. The interruption of supply of blood to the joint of the hip leads to the damage or bone cell death of femur head (thigh bone). Bone collapse or bone damage is because of ignorance or delay in getting the treatment.

Stages of AVN of hip

  • Stage 1 – The x-ray is normal. But MRI shows mild changes (cell death)
  • Stage 2 – Hip X-ray shows clearly visible changes. The shape of the femoral head (ball) is intact.
  • Stage 3- There are changes in the shape of the ball of the femur.
  • Stage 4 – There is clear evidence of femoral head collapse and cartilage damage in the x-ray.
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    Symptoms

  • Pain around the affected joint
  • Pain is mild to severe
  • Pain in the groin, pain can spread towards the knee and buttocks
  • Pain aggravates while putting weight on the affected hip joint
  • Restricted joint movement due to severe pain
  • Limping

    • Diagnosis

  • X-rays: To see the changes in the joint and bone, and to see the stage of AVN. The initial x-ray might be normal.
  • MRI and CT scan: Detailed joint images, more specific. Also, shoes if there is any soft tissue injury.
  • Bone scan: Helps visualizing inside the bones.
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    Treatment

    Conservative

  • Medications:Anti-inflammatory drugs, blood thinners, drugs to reduce the cholesterol level, etc.
  • As far as you can, stop placing weight on the affected joint. take rest and use crutches for offloading from your hip joint.
  • Exercises under the guidance of a physiotherapist to maintain joint mobility and to enhance the muscle strength
  • Bone healing instigated by electrical impulses

    • Surgery

    Required in most of the cases as people diagnose AVN when it becomes worse and conservative measures are not possible.

    Regenerative medicine

    Regenerative medicine is having good results in the early stage of hip AVN.

  • Adipose-Derived Stromal Vascular Fraction:

    It is a novel regenerative treatment that is able to treat Avascular necrosis of the hip. Early intervention can help arrest the progression of AVN. This procedure performed under local anesthetic agents.

    • What is SVF therapy / Cellular Therapy

  • The doctor draws 200 ml of fat from the abdomen within 40 minutes without the use of enzymes, chemicals, or any animal product.
  • Derivation of the SVF done using Australian patented technology.
  • This derived SVF injected into the affected knee joint.
  • In India and around the globe, thousands of patients have been treated with this technique.
  • It offers a minimally invasive solution for patients suffering from Hip pain due to early AVN.
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