Talk:Avascular necrosis

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Note[edit]

I'm 48 years old and have already had both shoulders replaced and my left hip replaced. I was diagnosed with avascular necrosis (AVN) in January of 2004. It seems I have to have a major joint replaced every two years. First was my right shoulder in July of 2004, then my left hip in August of 2006 and I'm currently recovering from left shoulder replacement surgery done March of this year. I also have AVN in my right hip and in both knees. So I will have more surgery in the future. Not only did I have to deal with the pain prior to surgery, but I also lost range of motion and strength. I have been lucky in finding a specialist who does not hesitate to perform the surgery when the pain is too unbearable. However, I was referred to this specialist by my regular orthopedic doctor/surgeon. My regular orthopedic doctor did not feel equal to doing the surgery due to my age. I can say from my experience, it is much better to go through the surgery and rehab than to experience the pain I had prior to surgery. One can get off the pain meds too, at least for awhile when one has more than one joint involved, and not worry about getting addicted to those pain meds. Plus, I have been able to get most of my range of motion and strength back. Just have a positive outlook and you'll be fine. Good luck, cdc (Tig1spaz2 (talk) 02:23, 13 April 2008 (UTC))

Surgery[edit]

My husband was diagnosed with avascular necrosis and was told that it did not matter when he decided he wanted surgery,that his condition would not worsen over a period of time.That was about 3yrs ago. now he is having such extreme pain continously and even his pain medication is hardly touching the pain.He is 46 yrs old , what are the risks and longterm pros on this surgery? He has an app. with another surgeon this month to talk about the surgery and to get a second opinion> thanks, fw___4.230.132.9 14:33, 18 July 2007 (UTC)

i don't know how much help i can be.. i'm 22 years old and have been suffering from AVN for 3 years. i have been told that they do not want to perform surgery until i am older. i do know that i'm forced to wait because replacement bones usually only have a lifespan of approximately 10 years. the recovery from the surgery is a very long one, approximately 6 months to a year, and will include regular physiotherapy, for the affected joint. the benefits, i assume, would be less pain, and more use of the joint. although i would think that there would still be some stiffness and a little bit of pain from time to time.

My son is only 7 and has this, it is in his right hip and he is trendelenburn negative. At the moment we have been told just to modify his activites (no sport) and treat with analgesics. I am so worried about what the future holds for him. Should I let him enjoy as much as he can now as he is not complaining of being in any pain at the moment. he was born with double dislocation that was never picked up until he was 2. He has already had 3 lots of surgery. His future sounds like it is going to be full of pain and surgery. You are only 22 what do you think? He wants to play tennis and cricket. ````9 February 2008 —Preceding unsigned comment added by 203.191.182.143 (talk) 23:58, 8 February 2008 (UTC)

Hi, I'm 21 years old and was diagnosed with Avascular necrosis of my left talus bone when I was 12 years old. My doctors told me the same thing that it looks like they've told your son. To stay off it and not play any high impact sports so that I wouldn't injure it further. That doesn't mean that he cant play any sports. I would suggest swimming or water polo. He could still get great exercise and have the commrodery of being on a team with water polo without putting stress on the hip joint. I understand though that your son probably is dead set on playing tennis and cricket. I was was in a similar situation with baseball. In my situation I continued to play until I was no longer able to because of the pain. I've since had one surgery to remove free floating spurs, and to clean up my joint. I also have had several injections of Hyaluronic acid, which helped a little but is painful. Being that your son is very young my advice would be to to encourage him to alternate between cricket and swimming because it seems like there is less running in cricket than tennis (im not really sure). And eventually turn him on to Water Polo. Its alot more fun than swimming and if you encourage him i think he would really take to it. The most important thing is to let him be a kid but to also preserve the affected AVN area (Buster26 (talk) 01:12, 18 June 2008 (UTC)).

Cricket would work: It is perfectly acceptable for someone to 'run for you' while batting and fielding isn't very active.Mattinkent (talk) 19:11, 1 September 2009 (UTC)

I'm 48 years old and have already had both shoulders replaced and my left hip replaced. I was diagnosed with avascular necrosis (AVN) in January of 2004. It seems I have to have a major joint replaced every two years. First was my right shoulder in July of 2004, then my left hip in August of 2006 and I'm currently recovering from left shoulder replacement surgery done March of this year. I also have AVN in my right hip and in both knees. So I will have more surgery in the future. Not only did I have to deal with the pain prior to surgery, but I also lost range of motion and strength. I have been lucky in finding a specialist who does not hesitate to perform the surgery when the pain is too unbearable. However, I was referred to this specialist by my regular orthopedic doctor/surgeon. My regular orthopedic doctor did not feel equal to doing the surgery due to my age. I can say from my experience, it is much better to go through the surgery and rehab than to experience the pain I had prior to surgery. One can get off the pain meds too, at least for awhile when one has more than one joint involved, and not worry about getting addicted to those pain meds. Plus, I have been able to get most of my range of motion and strength back. Just have a positive outlook and you'll be fine. Good luck, cdc (Tig1spaz2 (talk) 02:23, 13 April 2008 (UTC)) —Preceding unsigned comment added by Tig1spaz2 (talkcontribs)

I was 28 when I was first diagnosed with AVN in my left hip joint. Because of my age my doctor said there is no way he would operate on me. A year later and with further deterioration of the joint, I begged my doctor to do a total hip replacement. By now the only medication that would even touch the pain was long acting morphine. As the joint was so damaged a joint resurfacing was not possible. I had lost almost all quality of life and was pretty much bed ridden as I was no longer able to work or even drive a car. One week after my 30th, my surgeon performed the operation. Post-op pain was far far less than I imagined and after 5 days, I was sent home from the hospital. I was off crutches within 3 weeks and back to work after 6 weeks. That was 3 years ago and now I play squash once a week. Although during the winter, I tend to stiffen up, regular exercise keeps the joint mobile. Having the Total Hip Replacement was to be honest a piece of cake. I had a ceramic ball with a titanium shaft fitted. I have been told that I may get about 20 years out of this joint. When it comes to a revision when it finally wears out, all they do is drop another shaft in as there is no cement involved. The joint is held in by gravity. To me, this operation has given me my life back and if the AVN decides to attack me in the other hip, there is no way I would wait as long as I did for surgery. You only have one life to live - best not to live it in agony when it many cases, it can be fixed. - Johnathan Maltby, New Zealand. 2008 —Preceding unsigned comment added by 123.255.30.21 (talk) 22:34, 16 July 2008 (UTC)

Jacobs Story[edit]

Hello, my name is Jacob and in June 2008, I had a dirt bike accident which broke my femur into three pieces causing me to end up suffering from ‘AVN’ in the femoral head. I went into surgery around midnight and the surgeon put the femur back into position immaculately. This then meant that both my legs stayed the same length. I came out of surgery early hours of the morning. The following 2 weeks were spent in hospital making sure everything was ok. During the first week I had to get several X-rays, bone density test and blood flow test. The blood didn’t come back meaning that I was diagnosed with ‘AVN’. The doctor told my parents and I that if I didn’t receive the new drug Bisphosphonate, which was a drug that was and still is on trial, that my femoral head would collapse and I would need to stay in a wheelchair until I was old enough to get a hip replacement. I was all set up to receive the drug through a drip but later on that day when my parents got back to the hospital, they were told that Dr. Slaughter had declined the drug because it had not been on trial long enough and they didn’t know the side effects of it. Me and my parents thought that it was the end of the world but Dr. Donald from the Royal Children’s Hospital Brisbane had come up with a plan to try and save my femoral head. The doctors said to purchase a wheelchair from somewhere, so we did. The plan was to stay in the wheelchair for one year and come back every three weeks for a regular check up to see whether or not my hip had started to collapse or not. After about four months the blood had started to come back and this is when I entered the danger period. After five months of being in a wheelchair it looked like my hip started to collapse so the Dr. Donald came up with a new plan. It was to remove my seven screws and one plate from my leg and get a MRI to be 100% sure if it was collapsing and if it was to put on a hip distracter or to just take out the plate and screws and just put the distracter straight on. We decided to just put it straight on to be safe. The positives of the distracter were that it took all of the weight and you could get back to doing normal sports that didn’t require contact like tackling. The cons of it were that you had the chance of getting infections around the pin sights but if you made sure they stayed clean you wouldn’t get them as often. The doctors said it would be the worst thing but really it was just a walk in the park with it on, I thought. After going to monthly check ups to see if it was doing its job, which it was, I got it taken off. I currently hold the record for keeping the distracter on the longest (7months, 12days) in the Royal Children’s Hospital Brisbane. With the frame on I got to go body boarding in the surf, play with the kids and school and much more. When I got the frame removed in June 09, I got to go on crouches and start weight bearing for the first time in one year and a half which was a great feeling. Noelle was a great person to take care of the kids with frames. I had to start of toe touching for the first month-two months. After this period I went to a check up and Dr.Donald and Kylie (physio) said that I was able to start putting my whole foot on the ground and start walking but with the crouches still. Every couple of weeks I would go to my physio appointment with Kylie and after my first few appointments Kylie got me to start walking for the first time in one year and a half. It was extremely scary but it was the best feeling you could ever imagine. On October the 19th 2009 I went to a check up and my femoral head had no signs off collapse what so ever and the Doctors, Physio and Noelle told me that I was allowed to start walking 24/7 which was awesome. So far I have had no collapse what so ever and it is all thanks to the wonderful staff at the Royal Children’s Hospital Brisbane, Australia. If it wasn’t for them who knows what would of happened. Remember, you don’t need Bisphosphonate to get through ‘AVN’, as I have shown.

Special Thanks to Dr.Donald, Kylie and Noelle, use were the best. =]

Advice for you: -do everything the doctors tell you to no matter what even if you feel you are right

                           -think twice before taken Bisphosphonate
                           -have a positive outlook on the future
                           -if someone tells you, you’re a chicken for not trying to do something, whatever you do,
                            don’t do it  —Preceding unsigned comment added by 110.20.32.76 (talk) 11:23, 21 October 2009 (UTC) 
                            


MY NAME IS MISTY WHEN I WAS 10 YEARS OLD I WAS TOLD I HAD AVN THIS WAS BACK IN 1990 THERE REALLY WASN'T MUCH TREATMENT AT THAT TIME MY HIP DID COLAPS AND I HAD SUGERY TO HAVE MY HIP FUSED TOGETHER THEY ALSO HAD TO TAKE AND INCH OFF MY LEG I WAS IN A BODY CAST FOR 8 MONTH AFTER THAT I WALK WITH A LIM AND NOT BEING ABLE TO BEND DOWN TO EVEN TIE MY SHOES IF I SAT ON THE FLOOR I HAD TO HAVE MY BACK UP AGAINST SOMETHNIG I HAD A LOT OF BACK PAIN DUE TO THE SHORTING OF MY LEG THIS WENT ON FOR 13 PAINFULLY YEARS I WAS SO EMBARRASSED GOING TO SCHOOL HAVING THIS CONDITION ELEM SCHOOL WAS THE MOST DIFFICULT I WAS TEASED EVEN BY A TEACHER THAT CALLED ME CRIP AT THE AGE OF 23 I HAD MY 1ST HIP REPLACEMENT THE DOCTOR HAD TOLD ME MY LEGS WERE BOTH GOING TO BE THE SAME SIZE I CRIED SO HAPPY I COULD BEND DOWN TOUCH MY TOES OR TIE MY SHOE AND NO LONER WALK WITH A LIMP I'M NOW 31 I HAVE HAD 2 WONDERFUL CHILDERN I HAD THEM THE OLD FASHION WAY ;~) I WILL BE GETTING MY OTHER HIP REPLACED SOON HIP REPLACEMENT HAS BEEN THE BEST THING THAT EVER HAPPEN TO ME BESIDES MY KIDS IF YOU LIKE TO CHAT MISDESTAR1013@YAHOO.COM

DISCLAIMER[edit]

Stryker can only support information that has been generated by Stryker. It expressly disclaims responsibility for additional content written on this page. —Preceding unsigned comment added by Homerstrykercenterlibrarian (talkcontribs) 19:58, 14 December 2007 (UTC)

External links[edit]

External links on Wikipedia are supposed to be "encyclopedic in nature" and useful to a worldwide audience. Please read the external links policy (and perhaps the specific rules for medicine-related articles) before adding more external links.

The following kinds of links are inappropriate:

  • Online discussion groups or chat forums
  • Personal webpages and blogs
  • Multiple links to the same website
  • Fundraising events or groups
  • Websites that are recruiting for clinical trials
  • Websites that are selling things (e.g., books or memberships)

I realize that some links are helpful to certain users, but they still do not comply with Wikipedia policy, and therefore must not be included in the article. WhatamIdoing (talk) 07:07, 17 January 2008 (UTC)

Ficat Scale[edit]

69.120.224.194 (talk) 17:09, 17 January 2008 (UTC) It is my understanding that the diagnosis of osteonecrosis makes frequent reference to the Ficat scale. It would be useful to include a defintion of, and/or link to the Ficat scale for supporting reference.

Thanks very much

69.120.224.194 (talk)

This article is almost a copy of this website[edit]

This article is almost a literal copy-paste from: http://healthlink.mcw.edu/article/926046182.html . We have to work on this. This is definitely valuable information, but it is simply a copy-paste from a copyrighted paste, and that is unacceptable. The article must be rewritten. I will try to spend attention on this in the coming days / weeks. The article is on my watchlist. --Piz d'Es-Cha (talk) 19:07, 2 August 2008 (UTC)


Has this been remedied?74.15.42.191 (talk) 18:32, 27 January 2014 (UTC)

bisphosphonates, good or bad?[edit]

how can bisphosphonates be cited as a possible cause as well as a treatment for AVN???76.71.96.67 (talk) 19:33, 4 February 2010 (UTC)

Living with Avascular Necrosis and relief thereafter[edit]

I have lived with Avascular Necrosis that affected my hips. The cause was prolonged usage of Steroids to beat off the side affects of Tubercular Menengitis.

I went through and survived tubercular menengitis in 1995. Later that year, I started getting shooting pains down my legs. It was discovered that I was suffering from Avascular Necrosis in both my hips, but more so in my right hip. I lived with that condition till 2009, when the suffering became too much and the femur head of my right hip was reduced to a stump! I went through THR where the femur head was replaced with a ceramic head, which is said to have a lifespan of 20 years. My left hip is still affected, but not to such a great extent that it causes pain. My right hip is now fully functional, although I need to take care as to not twist it to certain positions.

If anybody wants more information about the experience, please feel free to put in a post below.

Mahesh av (talk) 18:02, 18 August 2010 (UTC)

avascular necrosis and stem cells[edit]

Hi,

 iam here to offer most recent but proven stem cell therapy for avascular necrosis wherein using your own cells you can regenerate your hip joint, for more details contact drdineshp@regrow.in  —Preceding unsigned comment added by 203.199.90.29 (talk) 10:34, 17 March 2011 (UTC) 

LIETRESE[edit]

HI MY NAME IS LIETRESE A 35 YEAR OLD FEMALE .I HAVE LUPUS AND ON MAY 16,2011 I WAS TOLD THAT I HAVE AVASCULAR NECROSIS HE ALSO SAID THAT I NEED TO HAVE BOTH OF ME HIPS REPACE AND THAT AT MY AGE THEY MY NOT DO IT . I AM ALWAYS IN PAIN IS I AM HOPING THAT THEY WILL GO ON AND DO IT AND I HOPE IT WORK OUT FOR ME I HAVE TWO KIDS THAT I HAVE TO LIVE FOR AND I NEED TO BE ABLE TO WALK AND GET AROUND . SO KEEP ME IN MINE WHEN YOU PRAY —Preceding unsigned comment added by 98.230.117.130 (talk) 02:02, 19 May 2011 (UTC)

Avascular necrosis[edit]

My name is Bonita S., and I am 74 years old, and live in Colorado. I have had two hip replacements, the first in 2007; after severe pain which all settled in my knee, diagnosed as avascular necrosis. Surgeon called my condition genetic, as my younger brother had Legg-Calve-Perthes disease when he was about 5 yrs. old. Also said only 5% of hip disease is due to avascular necrosis. I understand children usually outgrow it; true in brother's case, after he was on crutches for several years. I got along well, except for the lifetime restrictions, which can be a problem. About a year ago I started having pain localized in the other hip; was much more painful, and surgeon thought it was arthritis. It was replaced a few weeks ago, and I was told surgeon now thinks this may be more due to avascular necrosis than Perthes; though I need to clarify that with him. This recovery seems more difficult, though I am just a few weeks along. Don't look forward to all the lifetime restrictions, but am grateful I will be rid of the pain. Surgeon said if careful the artificial hips may last up to 20 years at this time. — Preceding unsigned comment added by 75.71.65.2 (talk) 23:23, 3 September 2011 (UTC)

AVN[edit]

I was told the other day I have AVN in my shoulder. As you know the pain is un real. I would like to know does it get better after the bone is done decaying? how long does it last? Does it ever go away? I am so confused my dr. wants to take more xrays in 2 months but I really don"t think I can wait that long. Is there special drs that knows what to do as far as surgery?

any help would be greatly helpful

Thanks Linda lg302211@centurylink.net — Preceding unsigned comment added by 184.4.241.84 (talk) 19:31, 19 September 2011 (UTC)

Rx warning.png We cannot offer medical advice. Please see the medical disclaimer, and contact an appropriate medical professional.

Living with AVN for years because of the insurance companies.[edit]

I am 46 and I have had AVN in both of my hips from the age of 31. It changed my life. My insurance dropped me in the middle of dealing with it. and refused to pay my doctor. Leaving me with all of the bills. Over the years I have just lived with it without any pain meds or doctors. I wish I could get hip replacment, but I have never had the money or insurance to do anything about it. I finally have a job that has good insurance but I believe that they will not cover it because I have had it for so long. I have not started going to the doctor for it yet, so we will see. But I will not be able to take the time needed for it, from work. Bills have to get paid. I have just learned to live with it. I have been a single dad and raising my daughter who is now 17. I played with her and I go places with her and walk long distances. I have found that just living live and never getting into those scooters at Walmat. That I have been able to make it. walking makes my hips feel better and keeps them loosened up. Beause I can no longer jog or hike. I have put on way too much wieght over the years. I need to work on that. I feel that this will help out quite a bit. I never take any pain meds and I just keep active the best I can. I have my bad days, and I have to make alterations in life. But I am making it all work. I work a job that is 12 hours a day. I drive a delivery truck and have to unload product. I just do it. I cannot jump onto the truck like other. but I have the lift gate on the back. I just cannot give up. I would say that it is my daughter that keeps me going. I do hope that I can get hip replacment some day. I know that it is coming thatI will have to stop. But I have never found it to be getting any worse over the years. You get use to the pain and you learn how to move in new ways to get as much of the same thing done as when you were able bodied. So those of you that are not getting the support from the insurance companies and cannot do anything about it. You can live with it. Just keep on moving and never take the easy way out — Preceding unsigned comment added by 63.170.254.21 (talk) 14:22, 13 November 2012 (UTC)

Progressive/ High-outcome Surgeries[edit]

There is a general lack of exposure of "cutting-edge"; i.e. newer and high-outcome surgeries in this article.

China, Korea and India have both approved a procedure known as Autologous Osteoblast Implantation (ABI; a.k.a. OSSRON). This procedure has proved to be effective in it's limited application.

Additionally, the citation that Core Decompression (CD) + Stem Cells has not been proven to be effective is false. Maybe by the way of insurance companies (how do they process credibility?), but there are more than 10 studies verifying a statistically significant and greater outcome in CD + SC patients versus CD alone.

I feel this is information is relevant, especially to the AVN grade 1 and 2 patients. Also Hyperbaric Oxygen Therapy (HBOT) has been shown in 3 studies (one with 100+ patients), to actually cure AVN. That is the femoral head regains complete circulation and there is no remnant dead bone. This is not the case with all other surgeries (those in which a lack of necrotic bone progression is defined as success, versus a return to an actually non-necrotic femur head).

This information is vital to AVN Grade 1 and 2 sufferers. Why insurance does not approve these methods (for the most part, on occasion they approve CD + SC) is beyond me, but it is not evidence-based and is likely profit-based (in some sick way).

Good luck everyone!!!! — Preceding unsigned comment added by 72.171.0.142 (talk) 02:26, 10 February 2013 (UTC)

Athletes with AVN: Updated[edit]

Magglio Ordonez, a former outfield of the Detroit Tigers (among other teams) had lack of blood flow to a portion of his knee (Knee AVN) in 2004. He went to Vienna Austria for Electrocorpeal ShockWave Therapy. It worked and he returned to have a near-MVP season in 2005, batting .363 with 28 HR's, 54 2B's and 128 RBI's.

Coagulopathies[edit]

Anyone who has AVN that is termed idiopathic, ie there appears no particular cause for it, should have coagulation studies done; AVN can be caused by blood clots within the bone matrix. The coagulopathy can be either a too-rapid process or it can be caused by such diseases as von WIllebrand's in which the clotting time is up and down (not every type of vWD has this see-saw effect.) (Bleeding times of 8 minutes+ raise the possibility of vWD and related) WIll try to dig up a link.

BTW - all of you who post here should know that the talk pages are not a forum for grievances or medical advice, but have to do with the actual article on the next page.74.15.42.191 (talk) 00:04, 27 January 2014 (UTC)