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, a microbial event is not a matter of speech. It accounts for the femur bone, which forms the most hip joint in the body. The circulation of the head of the femur bone in the hip joint is impaired for an unknown reason. The cells in the parts of the bone that can’t get blood begin to die. If untreated, bone death spreads to the sub-cartilage tissue, and the upper part of the bone, which carries the weight, collapses and the cartilage is destroyed. With the destruction of the cartilage, calcification, that is, arthrosis, occurs at a level that can no longer be repaired in the joint.
The exact cause of avascular necrosis is unknown. It has been shown to be related to alcohol use, diabetes, obesity, cortisone use and deep water diving together with the nose. In our country, especially long-term use of cortisone is one of the reasons we frequently encounter. It occurs most frequently in the 30-50 age group. If it is in one hip, the probability of being in the other hip joint reaches 70%. The disease can be quite insidious. It first manifests itself with a slight pain in the groin. Especially with walking a lot and standing a lot, the pain increases. Later, the pain is followed by limitation of movement. It is obvious that there is a limitation especially in the inward and outward rotation of the hip. Easy movements such as crossing legs and wearing socks, which are easily done in daily life, become impossible. In general, patients apply to the doctor when the pain intensifies and movement restriction begins. If the disease progresses insidiously, the application to the doctor is delayed even more.
How is avascular necrosis diagnosed?
The most valuable clue for early diagnosis is to take the patient’s groin pain seriously and consult the doctor early. X-ray, but since the disease progresses, the diagnostic system to be chosen for early diagnosis is MRI of the hip joint. MRI allows the diagnosis to be made while the disease is still in primary care.
What are the classical treatment systems in avascular necrosis of the hip?
The most valuable and easiest approach in avascular necrosis of the hip is to reduce the load on the hip joint. The patient is told not to stand for long and not to tire himself. Crutches or walking sticks should be used at this stage. Drug treatments, especially bisphosphonate treatments, are effective at an early stage. Hyperbaric oxygen and ESWT treatments may be effective again at an early stage. Surgical systems such as decompression and autologous bone grafts may, but not always, protect the bone from collapse in early events. In advanced events, cartilage needles added can slow down the progression to calcification by reducing joint friction. Again, at this stage, physical therapy systems are also used. Training is the only treatment system that should be applied at every stage of the disease.
In very advanced cases, joint prosthesis is required. However, the fact that the age of these events is young for prosthetic surgery is a very valuable problem. A second prosthesis operation may be required due to the loosening and aging of the early prosthesis in the following years. For this reason, early diagnosis and treatment in these patients is extremely valuable to prevent calcification of the hip.
Can PRP therapy be an alternative treatment for hip avascular necrosis?
PRP is the abbreviation of the initials of the English word “Platelet Rich Plasma” and means “platelet rich plasma”. In this method, since the drug is prepared from the patient’s own blood, it is a natural treatment technique that has no side effects. The high growth factors contained in the PRP fluid prevent cartilage damage. Recent information on PRP draws attention to the positive results and potential use of this treatment in avascular necrosis of the hip. Our experience also supports the positive results of the PRP procedure in this difficult-to-treat situation and indicates that it is a promising alternative formula.
The most adequate treatment for avascular necrosis of the hip is early diagnosis.