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Old 03-09-2002, 10:26 AM   #1
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johnsonk59 HB User
Question Avascular Necrosis

Hi my name is Keith i have just been diagnosed with Avascular Necrosis in both hips brought on by treatments for Hodgkins especially Prednisolone(steroids).Has anyone else out there had this if so what treatments did you have.I am 18 months post chemo,and 46 years old.
Thanks Keith.

 
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Old 05-10-2002, 10:38 AM   #2
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I never come to these boards. Don't even know why I did, but my husband died of non-hodkins lymphoma 12 years ago. He had avascular necrosis due to prednisone. He was unable to walk. I am sure in the 12 years since his passing there are many more treatments that are successful.

 
Old 05-11-2002, 09:24 AM   #3
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Although there is still some controversy about this treatment, hyperbaric treatment seems to be the likeliest potential non-surgical for AVN.

This is the treatment usually given to deep sea and scuba divers suffering from the "bends". The reason this is likely to work is that prednisone, cancer therapy or some other cancer-related event[s] somehow interferes with the proper oxygenation of the tissues and/or the transport of oxygenated blood to tissues including bone. BTW, hyperbaric treatment [at 2 atmosphere pressure] is also sometimes used to treat serious/extensive burns.

What makes this treatment controversial is that historically AVS/AVN has been treated surgically [by orthopedic surgeons] usually by removing/replacing the affected joints. For cancer patients and anyone on long-term, high dose prednisone surgery is not an option considering the very high risks associated with any surgery due to higher incidences of post-op infection, very poor/slow tissue regeneration [wound healing], etc.

The U.S. is currently studying hyperbaric medicine/treatment for non-diving related conditions; the U.K. apparently has much more experience. Suggest you contact a physician with scuba/deep sea diving medicine, or look up the Royal Navy's medicos.

Another suggestion is to change your prednisone dosage schedule from every day to alternate days. This is currently being done for bone marrow transplant patients who have chronic Graft-Versus-Host-Disease - my child's situation. Or, change to one of the faster-clearing prednisone analogs - the regular prednisone takes over 24 hours to clear, some of the newer analogs stay in the body for only 8 hours.

Check the ACOR [Association of Cancer Online Resources], this is a non-profit online organization for cancer and cancer-related conditions. There are different support groups for different cancers, including BMT/PBSCT and GVHD.

Here's a link to the U.S. government clinical trials site for AVS/AVN. Unfortunately both clinical trials listed are only intended to investigate the incidences/evolution of AVS/AVN in cancer and not its treatment.
[url="http://clinicaltrials.gov/ct/gui/c/w2r/action/SearchAction?JServSessionIdzone_ct=lxnoi o5gj1&Term=avascular+necrosis&submit=Sea rch"]http://clinicaltrials.gov/ct/gui/c/w2r/action/SearchAction?JServSessionIdzone_ct=lxnoi o5gj1&Term=avascular+necrosis&submit=Sea rch[/url]

Regards,
Jay

 
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