Avascular necrosis is the slow decay of the bones caused due to reduction in the supply of blood to the region. This may result in joint aches and weak bones. If left untreated, it may also cause an eventual collapse and distortion of the weakened bone which may cause fractures, joint dislocations or severe arthritis.
Treatment for Avascular Necrosis
The goals when treating avascular necrosis are to ensure that the pain is reduced, the progression of the bone damage is stopped and the functioning of the affected joint is rehabilitated. The best treatment options available to a patient will be determined by a number of factors which include the patient’s age, severity of the disease, location and amount of bone damage and causative factors for the disease.
Treatment for Acute Avascular Necrosis
If the causing factor of the disease is identified, the treatment will focus on managing the underlying condition that gives rise to it. For example, if the disease is being caused due to blockage of your blood vessels by blood clots or fat deposits, the doctor can prescribe medication to dissolve the clots. If the blood supply is thwarted because the blood vessels have become swollen, the doctor may prescribe anti-inflammatory medicines to resolve the causative condition.
If avascular necrosis of the bone is diagnosed in its early stages, it presents more options of treating the symptoms and the causes. The first goal of the treatment is to reduce the patient’s pain. The doctor may suggest some pain medication and/or ask the patient to limit the use of the affected joints or bones. If the joints affected are crucially placed, such as the hip, knee or ankle, the patient might be advised to use crutches to take the weight off the damaged joint. The doctor may also prescribe supportive braces and recommend the patient to a physiotherapist who will give them a set of range-of-motion exercises to help them increase mobility of the affected joint.
Treatment for Chronic Avascular Necrosis
While the nonsurgical treatments can help to slow down the progression of the disease, most people usually require surgery. The surgical options that are available during the chronic stages of the disease are –
· Bone grafts, which involves replacing the damaged bone with a healthy bone from another part of the body
· Osteotomy, which involves cutting the bone and realigning its arrangement in order to relieve the stress on the joint or bone.
· Total joint replacement, where the damaged joint is replaced by a synthetic one
· Core decompression, where a section is removed from the inside of the bone in order to relieve pressure and to allow formation of new blood vessels.
· Vascularized bone graft, which is a very complicated procedure that involves using the patient’s own tissues to rebuild the diseased or damaged joints. The bone with poor blood supply is first removed and then replaced with the blood vessel rich bone taken from another site of the body.
Besides these treatments, the patient must take lots of rest and limit their steroids, cholesterol and alcohol consumption in order to reduce further bone loss.