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[Supertraining] Avascular necrosis Howard Galloway Mon Jul 14 05:15:47 2008

Unfortunately AVN of the hip is a serious condition which more often
than not progresses to osteoarthritis of the hip. The cause is not
certain however a common pathophysiologic mediator seems to be
increased intraosseous pressure. You do not mention the MRI stage
ofthe disease but presuming that the conventional xrays are normal and
the MRI shows no sign of collapse then the only treatmentthat seems to
have a chance of success is core decompression. Once the femoral head
has satred to collapse ther unfortunately seems to be an almost
universal progression to osteoartritis and hip relacement afetr
varying periods of time. The most well known suffer was Floyd Landis
who eventually underwet hip replacement.(although his condition was
caused by an old fracture)
To the best of my knowledge ther are no effective nonsurgical
interventions and the success of core decompression is much reduced
once collapse of the femoral head has happened. The prognosis is alos
determined by the percentage of the femoral head involved. greater tha
20-30% being largely regarded as a poor prognostic sign.
There is plenty of information in themedical and surgical literature
which can be accesed via the NLMs Pub Med site should you wish to read
further.
>From 20 years of experience asa musculoskeletal radiologist my advice
for what it is worth is by all means seek further orthopaedic opinions
but bear in mind the lack of proven non surgical treatments and the
high risk of femoral head collapse.
Good luck

-- 
regards
Howard Galloway
Chief Radiologist
Aspetar
Qatar sports medicine hospital