Hip Avascular Necrosis (AVN)
Hip Avascular Necrosis (AVN)
Avascular Necrosis (AVN) or osteonecrosis is a condition where the blood supply to the bone is disrupted. It commonly occurs in the hip and also may be involved in both hips.
Avascular Necrosis may occur spontaneously or of insidious onset (without a known cause). It may follow trauma, or be associated with some medical conditions. Sickle cell anemia, cytotoxic medications, chronic corticosteroid use, and excessive alcohol consumption have been linked with a higher incidence, however not everyone who takes corticosteroids, or consumes high alcohol, develops Avascular Necrosis and therefore exact mechanisms or not fully understood. Trauma that disrupts blood supply is readily understood to precipitate the development of Avascular Necrosis (AVN). This may result is severe functional limitations if hip joint collapse occurs. In advanced cases hip joint replacement is recommended.
The Professional Football and Baseball player Bo Jackson developed AVN after being tackled, and his professional Football career ended as he eventually had his hip replaced.
Patients desire conservative options to forestall hip replacement especially if it occurs earlier in life as hip joint replacement does not have an indefinite life span. The replaced hip will wear out and need to be replaced again in younger patients and there is the risk that it may not continually be replaced and in such case a hip fusion would be necessary. This makes Regenerative Medicine options such as Platelet Rich Plasma (PRP) and Stem Cell Therapy attractive conservative options as there is no ticking clock for lifespan of a hip joint replacement.
Another consideration is that Avascular Necrosis may often be progressive, leading to bone collapse or result in secondary osteoarthritis which further erodes the hip joint. Active patients and athletes with early non collapsed femoral heads need special counseling regarding risk for further progression and sports. Early Hip AVN treated with an emphasis on regeneration by Stem Cell Therapy may repair and prevent further progression, and aid in secondary osteoarthritis.
Regenerative Medicine focuses on regenerative and repair mechanisms. Healing is promoted by using growth factors in the Platelet Rich Plasma (PRP) and the reparative ability of stem cells. Dr. Lox has treated athletes from several sports who developed AVN and continued in their sport. This is an individualized assessment between Dr. Lox and the patient as to reasonable goals, extent of joint involvement with the AVN, and determining appropriateness for PRP and Stem Cell Therapy.
Degenerative arthritis is also associated with AVN. Prevention of progression of arthritis, and hip joint collapse are also indications to consider Platelet Rich Plasma (PRP) or Stem Cell Therapy. Preserving as many future treatment options as possible by attempting to repair or regenerate the AVN region of the bone, makes Regenerative Medicine options attractive alternatives to surgery.
Avascular Necrosis (AVN) is also referred to as osteonecrosis. Early treatment of AVN of the hip with PRP and Stem Cell Therapy may be a viable conservative treatment option. Contact Dr. Lox to review your case and individual needs.
Dennis M. Lox, MD, serves patients in the greater Tampa Bay area, including, Clearwater, St. Petersburg, Tampa, New Port Richey, Sarasota,Orlando and Spring Hill. He has been pleased to accommodate the needs of patients throughout Florida, the United States, the Western Hemisphere, and Europe, as well. Primarily located Clearwater, our office can be reached at (727) 462-5582. Call to schedule your visit today.