Avascular necrosis

What is Avascular necrosis?

Avascular necrosis is known by many different names. These include bone infarction, osteochondritis dissecans and osteonecrosis. Necrosis refers to cell death due to any injury, inflammation or trauma. Avascular mean that there is a lack of blood supply. In Avascular necrosis, due to the interruption of blood supply, bone death starts to occur. As the effected dead bone part stops functioning normally, it becomes weakened and eventually it can collapse. Hence, this is considered a serious condition. Avascular necrosis is a chronic disease and it requires to be managed for lifetime if it occurs. It tends to worsen with time. 

Symptoms of Avascular necrosis

In the initial phase of the disease, there are no symptoms present. Eventually, however, the patient develops pain complaints. This pain can be felt in different part of the body. These areas include the hip joints, the knee joints and the upper arm bone. This results in limitation of movement of the body. 

Causes of Avascular necrosis

There are a few causes responsible for developing avascular necrosis. Any trauma to the bone or the joint can result in avascular necrosis. Patients with narrowed blood vessels can develop the disease too. If the pressure inside the bone is raised, it can result in avascular necrosis. Any fracture of the bone or a joint dislocation can cause avascular necrosis. The disease can develop without having any definite reason.  

Risk factors of Avascular necrosis

There are a few risk factors associated with avascular necrosis. Patients who are taking high dose steroids for any disease, for example prednisone, are at high risk of developing avascular necrosis. Patient who drink heavily or have alcoholism problems are also more prone to developing the disease. Patients with cancer going through radiotherapy or chemotherapy are also at more risk to develop the disease due to the treatment they are taking. People who have had previous transplants are also at risk of developing the disease.   

Patients with cancer or diseases like systemic lupus erythematosus and sickle cell disease are also at higher risk. Patients who have HIV infection are also at risk. Certain metabolic diseases like Gaucher disease can also act as risk factors. Caisson disease is also a risk factor. Drugs like bisphosphonates are known to cause osteonecrosis of the mandible. People who have jobs which involve them staying in high pressure places, like the military and commercial drivers, are known to be at higher risk of developing avascular necrosis. 

Complications of Avascular necrosis

There are a few complications associated with avascular necrosis. The joints and bone can go through collapse. Also, this disease result in the patient experiencing extreme joint pain which results in them become immobile. Due to severe pain and collapse of the bone, the patient can become immobile within two to five years of developing the disease. This effects the patient socially, psychologically and also effects the economic or financial state of the patient. 

Lab Investigations and diagnosis of Avascular necrosis

After taking a detailed medical history, your doctor will do a complete general physical examination to rule out other similar diseases. In order to diagnose the disease, a few diagnostic tests are ordered. These include X-rays of bones and joints. More advanced technology is also used, which is known as magnetic resonance imaging. A bone scan can also be done, which is known as Dexa scan. In the early phase of the disease, the preferred diagnostic tests are Magnetic Resonance Imaging and bone scintigraphy. As in the early stage, the X-ray appears to be normal. 

Treatment of Avascular necrosis

Treatments include homeopathic treatment of Avascular necrosis, treatment through acupuncture and acupressure, psychotherapy, using conventional or allopathic treatments, dietary and herbal treatment of Avascular necrosis and others. 

Homeopathic treatment of Avascular necrosis

Homeopathy uses natural compounds from the nature to treat the patient's symptoms and the disease. It does not only focus on the problem or the pathology but also treats the person generally and improves the body health overall. It focuses on the entire person. It acts by maintaining and balancing the energy system of the body. It strengthens the body’s ability to fight against the foreign infectious agents and disease. This protective system is known as the immune system. Homeopathy also improves the functions of the body. It removes the diseases by acting on its root causes. The common remedies and medication used by homeopathy to treat avascular necrosis are Ars aib, Fl Ac, Merc C, Sabin and Nat Sil F. 

Conventional or Allopathic treatment of Avascular necrosis

The conventional or allopathic treatment of avascular necrosis is given by the orthopaedic specialist, a specialist doctor for bones. The allopathic treatment includes medication to help relieve the symptoms. Drugs are given to alleviate the pain and decrease inflammation in the joints and bones. This treatment can slow down the progression of the disease. The medications used are known as non-steroidal anti-inflammatory drugs (NSAID). NSAIDs include drugs like aspirin and ibuprofen. Other drugs can also be used known, these are known as Bisphosphonates. Alendronate is the Bisphosphonate used in this case. 

Surgical treatment of Avascular necrosis

There are several surgical treatments available for avascular necrosis. These include core decompression. In this surgery, a layer lying in the inner part of the bone is removed.  Another surgery known as bone transplant or graft can also be conducted. In this procedure, the effected or diseased bone is removed and a healthy bone from the healthy part of the body is implanted in its place. This is known as autografting. The bone of the patient can be reshaped. This is known as bone reshaping surgery, also known as osteotomy. During this, the shape of the bone or the joint is changed so the pressure on the necrosis part of the bone can be relieved.  In some patients, Joint replacement is done. The diseased joint is removed and an artificial joint is inserted to replace it during this procedure.  

Dietary and herbal treatment of Avascular necrosis

You should eat foods rich in calcium and Vitamin D. You should eat more fresh, dark green vegetables, for example, spinach and generally all vegetables. Fruits should also be increased in consumption. 

Other treatments

Hydrotherapy with warm water baths can also help with the pain symptoms. Massages, yoga and exercise has also proven to be beneficial. 

Precautions and prevention of Avascular necrosis

There are a few precautions to be undertaken to prevent the disease from occurring. These include avoiding risk factors. You should not consume excessive alcohol. If you have an alcoholism problem, seek care. You should exercise regularly and maintain a healthy lifestyle. Exercise will improve your body strength and flexibility.

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