The list of treatments mentioned in various sources for Avascular necrosis includes the following list. Always seek professional medical advice about any treatment or change in treatment plans.
The first step in getting correct treatment is to get a correct diagnosis. Differential diagnosis list for Avascular necrosis may include:
Hidden causes of Avascular necrosis may be incorrectly diagnosed:
Research all specialists including ratings, affiliations, and sanctions.
The following medical news items are relevant to treatment of Avascular necrosis:
Several treatments are available that can help prevent further bone and joint damage and reduce pain. To determine the most appropriate treatment, the doctor considers the following aspects of a patient's disease:
The age of the patient
The stage of the disease--early or late
The location and amount of bone affected--a small or
large area
The underlying cause of avascular necrosis--with an ongoing cause such as corticosteroid or alcohol use, treatment may not work unless use of the substance is stopped.
The goal in treating avascular necrosis is to improve the patient's use of the affected joint, stop further damage to the bone, and ensure bone and joint survival. To reach these goals, the doctor may use one or more of the following treatments.
Medicines--to reduce fatty substances (lipids)
that increase with corticosteroid treatment or to reduce blood
clotting in the presence of clotting disorders. Nonsteroidal
anti-inflammatory drugs may also be prescribed to reduce
pain.
Reduced weight bearing--If avascular necrosis is
diagnosed early, the doctor may begin treatment by having the patient
remove weight from the affected joint. The doctor may recommend
limiting activities or using crutches. In some cases, reduced weight
bearing can slow the damage caused by avascular necrosis and permit
natural healing. When combined with medication to reduce pain, reduced
weight bearing can be an effective way to avoid or delay surgery for
some patients.
Range-of-motion exercises--may be prescribed to
maintain or improve joint range of motion.
Electrical stimulation--to induce bone growth.
Conservative treatments have been used experimentally alone or in combination. However, these treatments rarely provide lasting improvement. Therefore, most patients will eventually need surgery to repair the joint permanently.
Core decompression--This surgical procedure
removes the inner layer of bone, which reduces pressure within the
bone, increases blood flow to the bone, and allows more blood vessels
to form. Core decompression works best in people who are in the
earliest stages of avascular necrosis, often before the collapse of
the joint. This procedure sometimes can reduce pain and slow the
progression of bone and joint destruction in these
patients.
Osteotomy--This surgical procedure reshapes the
bone to reduce stress on the affected area. There is a lengthy
recovery period, and the patient's activities are very limited for 3
to 12 months after an osteotomy. This procedure is most effective for
patients with advanced avascular necrosis and those with a large area
of affected bone.
Bone graft--A bone graft may be used to support a
joint after core decompression. Bone grafting is surgery that
transplants healthy bone from one part of the patient, such as the
leg, to the diseased area. Commonly, grafts (called vascular grafts)
that include an artery and veins are used to increase the blood supply
to the affected area. There is a lengthy recovery period after a bone
graft, usually from 6 to 12 months. This procedure is complex and its
effectiveness is not yet proven. Clinical studies are under way to
determine its effectiveness.
Arthroplasty/total joint replacement--Total joint replacement is the treatment of choice in late-stage avascular necrosis and when the joint is destroyed. In this surgery, the diseased joint is replaced with artificial parts. It may be recommended for people who are not good candidates for other treatments, such as patients who do not do well with repeated attempts to preserve the joint. Various types of replacements are available, and people should discuss specific needs with their doctor.
For most people with avascular necrosis, treatment is an ongoing process. Doctors may first recommend the least complex and invasive procedure, such as protecting the joint by limiting movement, and watch the effect on the patient's condition. Other treatments then may be used to prevent further bone destruction and reduce pain. It is important that patients carefully follow instructions about activity limitations and work closely with their doctor to ensure that appropriate treatments are used. (Source: excerpt from Questions and Answers About Avascular Necrosis: NIAMS)
Tools & Services:
Medical Articles:
Search Specialists by State and City
By using this site you agree to our Terms of Use. Information provided on this site is for informational purposes only; it is not intended as a substitute for advice from your own medical team. The information on this site is not to be used for diagnosing or treating any health concerns you may have - please contact your physician or health care professional for all your medical needs. Please see our Terms of Use.
Copyright © 2011 Health Grades Inc. All rights reserved. Last Update: 1 February, 2012 (2:39)
