What Is AVN of the Hip (Osteonecrosis)?
What if you woke up one morning with your hip hurting and this pain kept getting worse over time? You go to the doctor who tells you that the bone in your hip is dying and if you leave it like this, the joint will collapse, and you’ll need a hip replacement. That’s Osteonecrosis. We used to think that this disease was largely caused by a poor blood supply to the hip bone, which is why its other name is Avascular Necrosis. More often, Hip Osteonecrosis happens due to damaged progenitor cells. These are cells that live in your bone and make new bone. These cells can be damaged by steroid medications, chronic alcohol abuse, chemical exposure, or other things.
Unfortunately, in India with the recent pandemic of COVID and related high dose corticosteroid usage in patients, we’re seeing a spike and incidence of multiple young people with AVN changes in hips.
Available conservative treatment options include bisphosphonates, pain killers, ayurvedic meds and bed rest. All these modalities can help with some symptomatic improvement but unfortunately the disease progresses from stage 1 to late collapse in due time. If it progresses to late stages,Hip replacement will be the only option.
But,if this disease is caught early, it can be cured, and the hip can be saved. Traditionally, that’s been through the use of a surgery called Core Decompression. That’s when the surgeon drills a tunnel from the good bone to the bad bone. The idea was that since the dying bone is often surrounded by a hard shell, the surgeon needed to “decompress” this area. However, the procedure likely works because you’re dragging healthy bone marrow and its stem cells into the dying bone.
At Regenexx we evolved the procedure from a surgical core decompression to a ‘Percutaneous BMAC’ one using a trocar. That reduced the invasiveness from a surgery where a tunnel the size of a ‘AA battery’ is bored through the bone to one as small as a ‘Matchstick’. Less invasive proctedures mean a much quicker recovery and fewer complications. For example, our patients are able to get back to full (on average) in a few days while surgical core decompression patients need a much longer period(6-8 weeks) on crutches taking weight off of the surgical hip .Also the risk is higher for full hip replacement in surgical decompression as it weakens the bone further.
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Regenexx® Procedures provide non-surgical treatment options for those suffering from pain related to osteoarthritis, joint injuries, spine pain, overuse conditions, and common sports injuries. These medical procedures are only performed by highly-skilled doctors and are used to help reduce pain and improve function. Regenexx procedures have helped thousands of patients improve their quality of life, return to the activities they enjoy, and avoid the need for surgery or joint replacement*.
Dr. Venkatesh Movva
Dr. Movva was fellowship trained in Sports Medicine and was board certified in Pain Management. He incorporates his unique training into a minimally invasive, Non-surgical approach in his practice, providing various cutting edge treatments.