What is avascular necrosis, what consequences does it cause in the body?
Avascular necrosis, also known as aseptic necrosis, is a condition characterized by the death of bone cells due to impaired blood supply to the bones. As the name suggests, there is no microbial event. It mostly involves the femur bone, which forms the hip joint in the body. The circulation of the head of the femur bone in the hip joint is disrupted for an unknown reason. Cells in the parts of the bone that cannot receive blood begin to die. If left untreated, bone death spreads to the subcartilage tissue, the upper part of the bone that carries the weight collapses and the cartilage is destroyed. With the destruction of cartilage, irreparable calcification, that is, arthrosis, occurs in the joint.
The cause of avascular necrosis is not exactly known. Along with the nose, it has been shown to be related to alcohol use, diabetes, obesity, cortisone use and deep water diving. In our country, especially long-term cortisone use is one of the reasons we frequently encounter. It occurs most frequently in the 30-50 age group. If it is present in one hip, the probability of it occurring in the other hip joint is up to 70%. The disease can be quite insidious. It first manifests itself with a slight pain in the groin. Pain increases especially with walking a lot and standing for a long time. Later, the pain is followed by limitation of movement. Restriction is especially evident in the inward and outward rotations of the hip. Simple movements such as crossing legs and wearing socks, which are easily done in daily life, become impossible. Generally, patients consult a doctor when the pain becomes severe and movement restriction begins. If the disease progresses insidiously, consulting a doctor will be delayed further.
How is avascular necrosis diagnosed?
The most important tip for early diagnosis is to take the patient's groin pain seriously and see a doctor early. is to apply. Since x-rays only show symptoms when the disease progresses, the diagnostic method of choice for early diagnosis is MRI examination of the hip joint. MRI allows the disease to be diagnosed when it is at the first stage.
What are the traditional treatment methods for avascular necrosis of the hip?
The most important and simplest approach to avascular necrosis of the hip is on the hip joint. reduce your burden is to be done. The patient is told not to stand for long periods of time and not to tire himself out. At this stage, crutches or a cane should be used. Drug treatments, especially bisphosphonate treatments, are effective in the early stages. Again, hyperbaric oxygen and ESWT treatments may be effective in the early period. Surgical methods such as decompression and autologous bone grafts can protect the bone from collapse in early cases, but not always. In advanced cases, cartilage needles inserted into the joint can slow down the progression to arthritis by reducing joint friction. Physical therapy methods are also used at this stage. Exercise is the only treatment method that should be applied at every stage of the disease.
In very advanced cases, joint prosthesis is required. But in general, the fact that the age of these cases is young for the prosthesis operation is a very important problem. A second prosthesis operation may be required due to the loosening and wear of the early prosthesis in the following years. Therefore, early diagnosis and treatment in these patients is extremely important to prevent the hip from developing arthritis.
Can PRP treatment be an alternative treatment for avascular necrosis of the hip?
PRP in English “ It is the abbreviation of the initials of the phrase "Platelet Rich Plasma" and means "platelet-rich plasma". In this method, since the medicine is prepared from the patient's own blood, it is a natural treatment method with no side effects. The high amount of growth factors contained in PRP liquid prevents cartilage damage. Recent data on PRP highlight the positive results and potential use of this treatment in avascular necrosis of the hip. Our experience supports the positive results of the PRP method in this difficult-to-treat condition and indicates that it is a promising alternative method.
The best treatment for avascular necrosis of the hip is early diagnosis.
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