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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
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