VMPL
Jaipur (Rajasthan) [India], Octoner 12: Avascular Necrosis (AVN) is a serious condition in which the blood supply to the upper part of the hip bone, known as the femoral head, is reduced or disrupted. As blood flow is affected, the bone gradually becomes weak and may eventually collapse. The condition is not limited to elderly people and is increasingly being seen in younger patients as well.
According to Orthopedic and Joint Replacement Surgeon Dr. Naveen Sharma, there has been an increase in patients presenting with AVN following the COVID-19 pandemic. In some cases, the use of steroids during COVID-19 infection or a tendency toward blood clot formation associated with the disease has been considered a possible contributing factor. However, other major causes of AVN include prolonged or high-dose steroid use, excessive alcohol consumption, and serious injuries or fractures involving the hip or femoral neck.
Dr. Naveen Sharma said that several relatively young patients are now presenting with the condition. Many patients initially consider hip pain to be a minor or routine problem and ignore it for a long time, increasing the risk of disease progression.
Joint-Preserving Treatment May Be Possible in the Early Stages
The most important aspects of AVN management are early diagnosis and accurately determining the stage of the disease. In the early stages, AVN may not always be clearly visible on an X-ray, whereas an MRI can help detect early changes. Depending on the stage of the disease and the patient's condition, selected patients may be considered for joint-preserving treatments aimed at saving the natural hip joint.
However, not every patient with AVN requires hip replacement. If the disease is detected at an early stage and the femoral head has not yet collapsed, joint-preserving treatment options may be considered depending on the individual patient's condition.
Problems Increase as the Disease Progresses
As AVN progresses, the structure of the femoral head becomes weaker and gradually collapses. This can lead to damage and wear of the hip joint, eventually resulting in arthritis. Relying solely on massage, herbal remedies, faith healing or other unproven treatments can allow the disease to progress and may reduce the opportunity to preserve the natural joint.
When the femoral head has completely or significantly collapsed and the joint has sustained severe damage, total hip replacement may become the primary treatment option for many patients.
Misconceptions About Hip Replacement Are Also a Major Concern
Many patients become anxious when they hear the term hip replacement. They may fear that they will not be able to perform normal activities after surgery or that the artificial joint will deteriorate quickly. However, modern hip replacement techniques and implant technology have advanced significantly over the years.
Direct Anterior Approach Hip Replacement is a modern surgical technique in which the surgeon approaches the hip joint from the front. In appropriately selected patients, it may offer advantages in terms of early recovery and mobility. However, no single surgical technique is suitable for every patient. Factors such as age, bone quality, disease stage, body structure and other health conditions are considered while selecting the appropriate treatment and surgical approach.
Do Not Ignore Persistent Pain
According to Dr. Naveen Sharma, people experiencing persistent pain in the hip or groin area, limping while walking, difficulty putting weight on the affected leg, difficulty wearing shoes or socks, or restricted hip movement should consult an orthopedic specialist.
People who have previously received prolonged steroid treatment or have a history of excessive alcohol consumption should be particularly cautious.
If AVN is ignored for a long time, it can lead to hip arthritis and may also contribute to pain in the knees, problems involving the lower back, or the development of arthritis in the opposite hip. Therefore, delaying appropriate treatment for advanced AVN is not advisable. Prolonged disease progression can also result in shortening of the affected leg, which may make subsequent surgery more complex.
Dr. Naveen Sharma said that when AVN is diagnosed and treated at an appropriate stage, the chances of achieving a good surgical outcome are significantly better.
Experts emphasize that timely diagnosis is the most important factor in managing AVN. When the disease is detected in its early stages, joint-preserving options may be available for selected patients. Once the femoral head collapses, however, hip replacement may become necessary.
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AVN Cases Rising After COVID-19, Hip Joints Also Getting Damaged in Younger People