Everything about Aseptic Bone Necrosis totally explained
Avascular necrosis is a disease resulting from the temporary or permanent loss of the
blood supply to the bones. Without blood, the bone tissue dies and causes the bone to collapse., excessive
steroid use, post trauma ,
caisson disease (decompression sickness), vascular compression,
hypertension,
vasculitis,
thrombosis, damage from
radiation,
bisphosphonates (particularly the
mandible) and
sickle cell anaemia. In some cases it's
idiopathic (no cause is found). Rheumatoid arthritis and lupus are also common causes of AVN.
Presentation
While it can, by definition, affect any bone, and half of cases show multiple sites of damage, this disease primarily affects the joints at the
shoulder,
knee, and
hip.
Although it can happen in any bone, avascular necrosis most commonly affects the ends (
epiphysis) of long bones such as the
femur, the bone extending from the knee joint to the hip joint. Other common sites include the
humerus (the bone of the upper arm), knees , shoulders, ankles and the
jaw. The disease may affect just one bone, more than one bone at the same time, or more than one bone at different times. Avascular necrosis usually affects people between 30 and 50 years of age; about 10,000 to 20,000 people develop avascular necrosis of the head of the femur in the US each year. When it occurs in children at the femoral head, it's known as
Legg-Calvé-Perthes syndrome.
Diagnosis
Orthopaedic doctors most often diagnose the disease except when it affects the
jaws, when it's usually diagnosed and treated by dental and maxillofacial surgeons.
Because early x-rays are usually normal in the early stage of the disease, bone scintigraphy and MRI are the diagnostic modalities of choice since both can detect minimal changes at early stages of the disease.
Treatment
Avascular necrosis is especially common in the hip joint. A variety of methods are now used to treat avascular necrosis. The bone is broken down by osteoclasts and rebuilt by osteoblasts.
Other treatments include Core Decompression, where internal bone pressure is relieved by drilling a hole into the bone, and living bone chip and electrical device to stimulate new vascular growth are implanted; and the Free Vascular Fibular Graft (FVFG), in which a portion of the fibula, along with its blood supply, is removed and transplanted into the femoral head.
The amount of disability that results from avascular necrosis depends on what part of the bone is affected, how large an area is involved, and how effectively the bone rebuilds itself. The process of bone rebuilding takes place after an injury as well as during normal growth Other sports stars with this condition are former
NFL running back Garrison Hearst,
cyclist Floyd Landis,
NFL quarterback Brett Favre, professional wrestler
"Superstar" Billy Graham, wrestler Joe Heat,
NBA player
Jorge Garbajosa and the drummer/singer of the band, The Monkees,
Micky Dolenz.
Further Information
Get more info on 'Aseptic Bone Necrosis'.
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