Avascular Necrosis Of The Femoral Head (AVN)

AVN means Avascular Necrosis of the femoral head. The incidence of AVN hip is alarmingly increasing nowadays after the Covid-19 pandemic. Avascular necrosis occurs when bone tissues die due to loss of blood supply. It is also known as osteonecrosis and can produce tiny breaks in the bone, causing the bone to collapse. Usually, the procedure takes months to years. Avascular necrosis is a condition that is caused by a temporary or permanent loss in blood supply to the bone. It most commonly occurs at the ends of long bones.

Avascular necrosis can be caused by an injury, long-term steroid usage, a hypercoagulable state, or alcohol. Symptoms may include joint pain and a limited range of motion. Osteonecrosis of the hip occurs when the blood flow to the femoral head is disturbed. The bone in the femur head dies and gradually collapses if not properly nourished. As a result, the articular cartilage protecting the hip bones collapses, resulting in disabling arthritis.

We have witnessed an increase in heart attacks and strokes in patients who have recovered from Covid-19. We are also observing an increase in the number of patients recovering from Covid-19. The reason is increased inflammation in the end arteries. Unfortunately, even young and active people are being affected. It's diagnosed early using X-rays or MRI scans. Once AVN sets in, we cannot stop its progression, but we can definitely limit its rate of progression through medical and surgical treatment.

Nonsurgical treatment options include activity management, anti-inflammatory medications, injections, and physical therapy. Because avascular necrosis is a progressive disorder, surgery is usually needed. The treatment of AVN is determined by the stage at which the disease is present. Staging is normally done by taking X-rays and MRI scans. Different surgeries in the form of Core decompression, Bone transplant (graft)- These procedures, which include bone contouring (osteotomy) and joint replacement, can help strengthen the area of bone afflicted by avascular necrosis.

Joint replacement surgeries also vary from hemi replacement and total hip replacement. In total hip replacements, we have different types like cemented, uncemented, and hybrid. What type of replacement needs to be done is decided by considering the patient's age, level of activity, and bone quality. Once these replacement surgeries are done, the patient can go back to his work pain free and lead a quality life.

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