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AVN of The Hips Can Be In Knees As Well, Or Multi-Joint

avn of the hips

When is AVN Mulit-Joint?

Getting the diagnosis of AVN of the hips can be very intimidating. Most patients who are diagnosed with AVN go through a fear and denial period.

The doctors often give slim hope, and discuss the worst case scenarios. Often these scenarios include discussions of hip replacement surgery.

Sometimes patients are left to do nothing and wait till their joint crumbles, and then get replacement surgery. All distressing prospects.

Patients diagnosed with AVN of the hips will often do their research. They may come across that AVN in certain instances can affect multiple joints, especially if it is of systemic origin and not traumatic induced. Then, they begin to research alternatives to hip replacement surgery, which leads them to Regenerative Medicine and Stem Cell Therapy.

Patients view Regenerative Medicine, and Stem Cell Therapy as viable alternative treatment options to hip replacement surgery. Especially since avascular necrosis is most frequently seen in the hip, followed by the shoulder.

Hip AVN that is non-traumatic in origin can be seen in both hips. This calls for awareness and attention to both hips.

Dr. Lox has seen patients with both hips replaced due to AVN or osteonecrosis, without any attention to their knees. Only later it is discovered in both knees.

Dr. Lox has also seen extreme cases involving both hips, both knees, and both ankles. Even when both hips have already been replaced, patients are interested in Regenerative Medicine and Stem Cell Therapy options, as opposed to continuing to replace their joints.

A passive attitude of just letting nature have its way with their body, and do nothing until their joints fall apart is not appealing to most when they become more informed about AVN.

AVN or Osteonecrosis

Avascular necrosis or osteonecrosis occurs when the blood supply to a region of bone becomes impaired. This leads to bone cell death. Avascular means lack of blood flow, while osteonecrosis means bone cell death.
The problem of AVN is variable, and must be addressed with each particular patient. There is no uniform pattern.

The area of AVN, can be small and well defined, or large. If it is adjacent to the joint margin or larger the risk of the most feared complication of osteonecrosis is increased. This is a rapid joint destruction, due to collapse of the necrotic area. This can be viewed as an accelerated form of degenerative arthritis.

Regardless, AVN can be viewed as accelerated arthritis due to the nature of the problem: An impaired region of bone. We know that trauma accelerates arthritis, and thus AVN does as well.

Besides being termed avascular necrosis and osteonecrosis, other names all meaning the same thing have been used. These include aseptic necrosis, bone infarction, and a host of other names for doctors who often first described the disorder in a particular joint. Obviously, too many terms for basically the same underlying pathophysiological disorder is confusing.

Gaining Weight or Being Overweight and AVN

Gaining weight after being diagnosed with AVN of the hip, knee or ankle is problematic. This is because all the weight is transmitted downward.

Weight is magnified as a force load not a one pound to one pound ratio. It is amplified by say five fold. A 10 pound weight gain is a 50 pound force on the area of AVN.

The same holds true for being overweight initially when the diagnosis of avascular necrosis is made.

Frequently, patients complain it hurts to walk or exercise, thus rendering weight loss as a difficult endeavor. Dr. Lox knows this problem all to well.

Dennis M. Lox M.D. is an expert in Sports and Regenerative Medicine. He has an extensive background in diet and exercise for a variety of patients, not just athletes.

Understanding the science of diet and exercise, proper nutrition, and kinesiology of how different exercises can facilitate weight loss and exercise without compromising already damaged or painful body areas is something gained with vast experience.

A Case Study of AVN and Weight Gain

This patient with hip and knee AVN, gained 60 pounds in the last 12 years, due to pain and immobility. Previously, when she was younger she was active in ballet and gymnastics. There was an athlete underneath her weight gain, but she was frustrated due to the pain, immobility, and lack of understanding of what to do differently.

Dr. Lox recognized this trapped pattern. By personalizing an approach to her condition, he made specific recommendations.

Quite interestingly she had a lot of the tools already at home. She had a variety of nutritional supplements, protein powder, blenders and nutrients to add extra small nutritionally sound meals to her diet. Recommendations for avoiding processed sugar, flour and carbohydrate dense products were made. An exercise regimen was developed to work around her avascular necrosis.

She was use to snacking on bananas and nuts. A further discussion of dietary needs were made for her. She was delighted a doctor spent so much time with her.

A Personalized Medicine Approach to AVN

Dennis M. Lox M.D. practices Sports and Regenerative Medicine, with a personalized medicine approach tailored to each individuals needs. There is no one size fits all approach. Individualized personalized care must be individualized to each particular patient’s needs. Such an approach allows for the best possible outcome. This is true for avascular necrosis, as well as all medical disorders.

Dr. Lox practices this personalized medicine approach in the Beverly Hills, California metropolitan area of Los Angeles, and in the Tampa Bay, Florida area.


About Dennis M. Lox, M.D.

Whether you are a professional athlete, weekend warrior, or have arthritis from aging, Dr. Lox can help.

Dennis M. Lox, M.D. is an internationally renown Sports and Regenerative Medicine specialist. Dr. Lox incorporates Regenerative Medicine techniques such as cell science applications, Platelet Rich Plasma (PRP), and Tissue Engineering aspects, to help patients from around the world with a vast array of problems. Dr. Lox is board certified in Physical Medicine and Rehabilitation. Dr. Lox lectures extensively and has edited two PM&R textbooks, the prestigious A State of the Art Review (Star) on Low Back Pain, and Soft Tissue Injuries: Diagnosis and Treatment.

Dennis M. Lox, M.D. maintains an active practice in the Tampa Bay, Florida area, and in Beverly Hills, California.

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