Hip AVN: Avascular Necrosis
Hip AVN
Hip AVN or avascular necrosis, is the most common joint affected with AVN. However, not all AVN is the same causation or severity. AVN occurs when the blood supply to a region of bone becomes impaired, this leads to bone cell death or necrosis. This is much similar to a heart attack ( myocardial infarction) causing heart muscle cell death after blood flow to the heart is impaired (typically heart disease with clogged vessels). The amount of bone cell death and location is important for prognosis and treatment. AVN is like an accelerated form of degenerative hip arthritis. If the area of necrosis collapses, a rapid joint destruction may occur. Early treatment and assessment by an expert in AVN and Regenerative Medicine, such as Dennis M. Lox M.D., is optimal for preventive and Regenerative options. AVN or avascular necrosis, may be referred to as osteonecrosis as well. The hip is the most frequently involved, followed by the shoulder, then the knee. Unlike most other joints hip AVN frequently can be seen in both joints. So, a thorough specialist in the treatment and management of AVN, will look at both hips.
AVN Causation Factors
AVN or osteonecrosis has many causation associated factors many are rare. The most frequently seen AVN causation factors are:
- Trauma
- Idiopathic
- Excessive corticosteroids
Trauma Cause of AVN
Trauma is easy to identify after diagnosed, however initially most trauma hurts, and especially in sports it may be overlooked as pain from contact. When the pain does not subside in normal amount of time, or the pain is out of proportion to the injury AVN must be considered. Many famous athletes sports careers were ended due to untimely diagnosis of AVN. Perhaps the most famous being the great professional Football and Baseball player Bo Jackson. An MRI will review AVN changes much sooner than can be seen on x-rays, and an MRI shows much greater detail of bone involvement. Idiopathic or unknown is difficult, because everyone wants answers. Unfortunately, the second most common causation factor for AVN is idiopathic. An expert such as Dr. Lox has a full understanding of all the other potential causation factors, and these must be excluded before concluding it is indeed Idiopathic AVN. Excessive corticosteroids is seen frequently, as a causation of AVN. There are a lot of patients who are treated with corticosteroids and never develop AVN. However it is associated with prolonged higher doses, but has been even with lower doses. The same is true with another causation factor, excessive alcohol intake. AVN is rare in drinkers overall, and still rare in those who abuse alcohol, so there are mechanisms in excessive corticosteroids and alcohol that contribute to the development of AVN which are not completely understood.
Hip AVN and Regenerative Medicine with Stem Cell Therapy
Most often patients with the diagnosis of hip AVN seek consultation with Dr. Lox for return to sport, avoid hip replacement surgery, lead the most active normal life. Dr. Lox has treated patients from all across the United States and patients from all over the world. This his given Dr. Lox a unique experience in the management and treatment of hip AVN in patients who are teenage athletes to older patients with various disease states which resulted in the causation of AVN. This array has been from sickle cell disease, Lupus, Glycogen Storage Diseases, radiation and chemotherapy, and others. In the end, it is about the management and treatment of the patients AVN. Young patients with AVN wish to avoid hip replacement surgery, so do athletes, as their sport will be gone. Regenerative Medicine and stem cell therapy, works scientifically on various aspects of the AVN process. Repairing vascular flow through angiogenesis is a possibility early. Replacing dead bone cells via the stem cells differentiating into bone cells can occur as well. Younger and early is always easier. The inflammatory cascade response accelerates the degenerative arthritis progression. This can be affected to via the effects of cell therapy. If control of the degenerative versus repair phase is more balanced necrotic areas may not collapse and a slower course can be maintained by proper education on exercise, diet weight are all important factors to be discussed with an expert such as Dr. Lox. There is so much science, and each patient has a different personalized situation that must be addressed. That is the only way to get the best outcome.
