Avascular Necrosis

Avascular necrosis occurs when the blood supply to bone is cut off and the bone tissue dies. Another name for avascular necrosis is osteonecrosis. The disease can cause small breaks in the bone, eventually leading to its breakdown.

There are a number of causes for blood flow failing to reach a bone. One is bone fracture. Another is dislocation of a joint. The condition also is linked to excess alcohol use or taking steroid medications over a long period of time.

The disease is progressive and must be managed as long as a person lives.

The hip is the joint in the body most affected by avascular necrosis. The knees and shoulders also are commonly involved.

Avascular Necrosis Symptoms

Aside from the hips, knees and shoulders, other joints that can have osteonecrosis are the:

  • Feet
  • Ankles
  • Hands
  • Wrists
  • Jaw
  • Spine

Sometimes avascular necrosis occurs on both sides of the body — in both knees or both hips, for example. If an injury is the cause of the condition, symptoms may happen quickly. In other people, the pain and stiffness can slowly grow over a period of months. Sometimes there are no symptoms.

The most common symptoms are pain and reduced range of motion. When this occurs in the hip, the pain can extend to the groin, the thigh or the knee. When the knee is affected by avascular necrosis, most often the outside of the knee feels pain, which increases with movement. If it occurs in the shoulder, most often the upper arm bone feels painful.

Osteonecrosis Treatment Options

The aim of treating osteonecrosis is to reduce or prevent further loss of bone. Early stage disease can be treated with certain medications and therapy. More advanced forms of osteonecrosis may be treated surgically, including joint replacement surgery.

In the case of the hip, the most common site of osteonecrosis, a total hip replacement operation may be done. Other treatment options include medications such as nonsteroidal anti-inflammatory drugs, including aspirin or ibuprofen. Other medications used are bisphosphonates. According to some studies, drugs to treat osteoporosis, such as Fosamax®, may slow down the disease.

Forms of therapy include exercise guided by a physical therapist, rest including decreasing the amount of physical activity, and electrical stimulation. The latter may result in growing new bone to replace damaged bone tissue

Some patients will require surgery. Surgical procedures for treating avascular necrosis include:

  • Core decompression which entails surgically removing part of the innermost layer of bone to reduce pain and provide more room for the bone to grow new blood vessels and stimulate new bone growth.
  • Bone transplant, during which the surgeon takes bone from another area of the body to implant it into the area where osteonecrosis has occurred.
  • Osteotomy or bone reshaping. This procedure is done in more advanced cases of the condition. It involves reshaping the bone to decrease the amount of pressure placed on the region where the osteonecrosis is occurring.
  • Joint replacement such as total hip replacement. This is done when the diseased bone has already decomposed and other methods of treatment are not adequate. During this procedure the surgeon removes the diseased part of the bone and replaces it with an artificial bone implant.

When Hip Implants Fail

Replacement surgery is painful and debilitating. Artificial hip systems are expected to last a minimum of 15 years. Some patients that have received hip implants made by DePuy Orthopaedics have experienced excessive pain due to complications with the systems.

Two types of hip implants, made by DePuy, were recalled in August 2010 due to a high failure rates. The hips were failing in as little as five years, while most artificial hips are expected to last at least 15 years. The two recalled systems are the ASR™ XL Acetabular System and the ASR™ Hip Resurfacing System.

If your hip implant failed prematurely, requiring you to undergo painful revision surgery, a qualified hip implant lawyer can help you. Contact us for more information.

DePuy Hip Replacement Recall Information

DePuyHipImplantRecall.org intends to provide patients with up-to-date information about the recent DePuy hip implant recalls. For more information, please select from the following:

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