CHEEKS

Yes, the only way for your doctor to know if you have it is if he reviews your x rays and it shows prominent damage of the hip bones. In some cases the hip might not be bad enough to do a THR right away. Some surgeons advise patients to wait until you cannot live with the pain or discomfort. After being diagnosed I decided to wait until it got bad enough for me. I would strongly advise you not to wait. My hip started to deteriorate at a faster rate because of steroids and it fell out of socket. A week later I had what was supposed to be a total hip replacement ;however, when they went into my hip it was infected so they could only put in a temporary (spacer) that had antibiotics in it. Two years later I had my permanent put in. Avascular necrosis is where the bone does not get enough blood ;therefore, it causes the bone to start to break down. Steroids is known to be one of the main causes for this but it can also be from trauma to the bone itself. If you are in the early stages sometimes an x ray will not show if you have it but if you are experiencing symptoms then an MRI may show damage.

These are some of the treatments for it:


Core decompression. A hole is surgically drilled through the femur and into the femoral head to remove dead tissue and reduce pressure within the femoral head. The goal is to restore blood flow and encourage new bone growth to replace the dead bone that was removed. This procedure is effective for 70 percent of avascular necrosis cases detected in early stages.
Vascularized fibula graft. As with core decompression, a hole is drilled through the femur to remove dead bone in the femoral head. At the same time, a section of healthy bone from the fibula (the smaller of the two bones in the lower leg) is removed, along with the vessels that supply it with blood.
This bone segment is inserted in the hole drilled in the femoral head and is reconnected to the circulatory system. The bone graft provides support to compensate for the bone that was drilled away and, because it is well supplied with blood, encourages new bone growth in the femoral head.

The section of fibula removed for this procedure is not necessary to support the lower leg. Its removal puts no additional limitations on the patient's activity after recovery from surgery.

In some cases, the vascularized fibula graft will be supplemented with the use of a special protein that can promote bone formation. This protein, which was discovered at UCLA, can enhance bone formation.

Osteotomy. A wedge-shaped piece of bone is removed from the femur to change the position of the femoral head in the hip joint. The bone wedge removal rotates the femoral head so that an undamaged portion of the femoral head bears the weight that had been supported by the diseased portion.
This procedure works best in patients with limited damage to the femoral head, and is often used to treat avascular necrosis that follows trauma to the hip.

Total hip replacement. If the femoral head cannot be preserved using the above procedures, it may be necessary to replace it with an artificial hip joint.
This procedure is the last choice for treating avascular necrosis because of its complexity and the possibility that the artificial hip will need to be replaced more than once. Because artificial joints wear out with use; young, active patients may have to undergo additional replacement(s) of the joint over time.

I hope this is a help to you.
CHEEKS

[This message has been edited by CHEEKS (edited 06-19-2003).]

[This message has been edited by CHEEKS (edited 06-19-2003).]

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CHEEKS