Shoulder Avascular Necrosis (AVN) and Stem Cells
Tampa, Saint Petersburg and Clearwater,FL
Avascular necrosis (AVN) has many synonyms. Osteonecrosis, ischemic necrosis, aseptic necrosis, bone infarction all refer to the same process. Avascular necrosis (AVN), refers to a condition in which the blood supply (vasculature) becomes disrupted and the region of bone that is supplied with that blood dies (necrosis).
The terms osteo refers to bone and necrosis means cell death Thus, the term osteonecrosis. Ischemic and avascular both refer to loss of blood supply, and the terms ischemic necrosis or avascular necrosis, both reflect loss of blood supply and bone death.
Shoulder AVN is common, second only to the hip. Precipitating etiologies include trauma. Fractures of the humerus are prone to develop AVN, if the blood supply is disrupted. Steroid medications (cortisone) seem more prone to affect the shoulder in AVN. Idiopathic (unknown) causes, as well as some disease states (sickle cell, gaucher’s, caisson’s, lupus) are also seen as in AVN of other joints. Disorders that impair blood supply, vasculitis, thrombosis, and embolism are risk factors. Chemotherapy and radiation, also are risk factors.
AVN in the shoulder may be gradual onset or sudden as with trauma. Diagnosis is confirmed with X-rays, bone scan, or MRI.
Surgical options for treatment are generally invasive and associated with significant recovery.
STEM CELL THERAPY has been advocated as a conservative option for the treatment of AVN or osteonecrosis. The body attempts to heal with stem cells, as that is their function. Stem cells promote a healing response as well as differentiate into certain cells. However, in AVN the disrupted blood supply hinders this process by limiting access to the necrotic site. Also, with the aging process stem cell numbers decline, thus less stem cells are available to repair. This may be overcome by directly injecting the patients own stem cells into the area of vascular necrosis. These stem cells may be obtained from the bone marrow or fat (adipose) tissue. A reparative effect can be seen by injecting the stem cells. A new blood supply, as well as new bone growth may occur. Platelet Rich Plasma (PRP) may be used in conjunction with Stem Cell Therapy.
Platelet Rich Plasma (PRP) treatment is not a stem cell treatment, though success with PRP has been reported in some cases.
Athletes needs pose special considerations. Certain surgical procedures may end their career (shoulder replacement). Failure to treat promptly, may result in accelerated secondary arthritis with joint destruction. Dr. Lox has expertise in treating athletes with AVN and sports injuries. Each patient has unique goals and circumstances that must be considered with treatment. Dr. Lox will fully evaluate each patient for prospective treatment and consider goals, lifestyle and sports / athletic 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. Located in the 33765 and 33765 areas, our offices can be reached at (727) 462-5582 (Clearwater) and (727) 817-1909 (New Port Richey). Call to schedule your visit today.
