Why does the femoral head lose its blood supply?

When the supply of blood to the tissues in the head of the femur (thighbone) is prevented temporarily or permanently, the bone tissues die and forms cracks within the bones, which eventually collapse. This is often referred to as Osteonecrosis of the hip or avascular necrosis (AVN), or aseptic necrosis, a painful condition. Bone cells require a steady blood supply to maintain a healthy bone, but in the case of Osteonecrosis or AVN, it results in the destruction of the hip joint and also causes severe arthritis.

Osteonecrosis can affect any bone; however, the hip is the most common site of the disease. This is because long bone ends are the most commonly affected areas. The bones in your knees, shoulders, hands and foot are the other common areas affected by this condition.

Osteonecrosis can occur in one bone at a time, or various bones may be affected at the same time, or different bones may be affected at different times. 

Thousands of people are visiting hospitals every year and consulting hip specialists for the treatment of Osteonecrosis, especially to the hip. Dr. Ajay Kumar Tiwari, one of the best orthopaedic hip specialists in Hyderabad, says that Osteonecrosis mostly affects both hips at the same time.

What are the causes of Osteonecrosis?

As discussed above, Osteonecrosis of the hip is developed due to the lack of blood supply to the femoral head. It can affect anyone. But it is more commonly observed in people of age between 40 and 65. In addition, men are more at risk of developing Osteonecrosis of the hip than women.

  • Injury — Hip dislocations and hip fractures can damage the nerves that supply blood to the femoral head.
  • Blood vessel blockage caused by fatty deposits — The fat deposits (lipids) block the blood vessels in the bone, which eventually prevents the supply of blood to the bone.
  • Certain medical conditions — Diseases like Gaucher’s disease and sickle cell anaemia can prevent the blood supply. Radiation therapy treatment for cancers might damage blood vessels and makes your bones weak.
  • Unknown causes — In around one-fourth of avascular necrosis cases, the cause that prevents blood supply might remain uncertain.

Risk factors that tend to develop Osteonecrosis

  • Using steroid medications
  • excess consumption of alcohol
  • Prolonged use of bisphosphonates
  • kidney transplant
  • Diabetes
  • Pancreatitis
  • Systemic lupus erythematosus

Symptoms of Osteonecrosis

Osteonecrosis progresses in four different stages. Symptoms usually begin with hip pain. The pain may start with a dull ache to a sharp pain in your groin or buttock area. As the condition advances, standing and exerting body weight on the affected hip side becomes increasingly very difficult, and hip movement also becomes painful.

The progression of the disease may take a few months to more than a year. Therefore, diagnosing Osteonecrosis and providing early treatment is very important because early treatment gives better outcomes. 

Treatment for Osteonecrosis

The primary aim of osteonecrosis treatment is to manage symptoms and avoid additional bone loss. The doctor will decide the best treatment option for avascular necrosis depending on the following factors:

  • Patient age, general health, and previous medical history
  • The severity of the disease
  • Location and extent of bone damage
  • The underlying cause
  • The resistance of your body to certain medications, treatments, or therapies
  • Progression of the disease
  • Patient preferences

Osteonecrosis diseases in some people can be managed with conservative options, while others require surgical management for better outcomes. Both treatments help to improve functionality. Treatments are needed to keep joints from breaking down and may include:

Conservative treatment options to treat Osteonecrosis

  • Medicines — used for pain management.
  • Assistive devices — used to reduce weight bearing on the damaged hip bone.
  • Physiotherapy and different types of hip exercises
  • Lifestyle changes like preventing excessive alcohol consumption 

Electric stimulation and combination therapies may also be used to stimulate bone growth.

Surgical treatment options for Osteonecrosis

  • Core decompression — this is a surgical procedure in which the inner bone layer is trimmed so that the pressure reduces, increases blood flow, and slows down or prevents the damage of bone and joint destruction.
  • Osteotomy — in this surgical procedure, the affected bone is reshaped to reduce stress.
  • Bone graft — this is an innovative surgical procedure where the damaged bone is replaced with a healthy bone that is taken from another body part.
  • Joint replacement – This is an advanced surgical procedure that removes the damaged bone completely and is replaced it with an artificial joint. This treatment is used as the last resort when other treatment options are ineffective in relieving pain or disability.

If you are having any hip problems, consult Dr. Ajay Kumar Tiwari, one of the best Hip Specialists in Hyderabad. He is an expert orthopaedic surgeon who helped hundreds of patients suffering from different types of hip problems, including Osteonecrosis. Call +91 98499 82203 to book an appointment with the doctor right away.

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