I posted about avascular necrosis a few years ago. AvN is when the blood supply stops to the bone and the bone dies. My husband, now 33, had it in his right hip 2 years ago and the hip needed to be replaced. The surgery went great and he was fine for about a year. I am revisiting this now as he was just diagnosed with it in his left hip. It not clear about how he got AvN. From what I have read, it’s not hereditary. We wouldn’t know about that anyway, as he is adopted and has no idea who his biological parents are. Anyway, according to what I read, there are three major causes for the disease: 1. Steroid use 2. Alcohol abuse 3. Injury to the area. This seems to apply as he did have a few cortisone injections some years ago for carpal tunnel caused by guitar playing (he’s a musician). And, truth be told he did spend a few years mostly in the bottle. There was no injury to the area as far as we know. He goes to the doctor today to see how long until he has to have surgery, or if there is any alternative.
Does anyone know anyone who has AvN, and the probable causes for it? I know a lot of people who have had cortisone injections and who drink a lot more than he used to, and no hip replacements for them…I wonder if it was the combination that did it for him…Or maybe he is just one of the unlucky ones? What’s next? A knee replacement? Elbow? We joke about how “We Can Rebuild Him.” Well, on the upside, we like the little plastic card with a picture of a replaced hip that he shows to people when we go through metal detectors.
I do not know anyone with AvN, but from what I understand, it primarily affects ball-and-socket joints, which means the hip and the shoulder. I also have the impression (not definite knowledge… but I read about it in the Merck manual two weeks ago) that part of it is just bad luck–the vein gets stuck inside the joint, and is pinched shut.
Avascular necrosis is just what it says – death of tissue that has been deprived of blood, and thus oxygen. Arteries in the body are not uniformly distributed. Certain bones in the body have a very tenuous blood supply, and disruption of the local vessels thus has a serious effect. This would typically include the shoulder labrum, ligamentum teres of the hip (actually a blood vessel) and the scaphoid bones in the hand. Alcohol can be toxic to both blood and blood vessels. A few of you may have had to wear “scaphoid” casts after injuring your thumb, even if the X-rays showed no obvious injury, and avoiding AVN in the scaphoid bone of your hand is one reason why docs are overcautious regarding thumb injuries.
I have AVN. I was diagnosed with Lupus in 1980 and the treatment at that time was prednisone. Fifteen years later, I was diagnosed with AVN of the right hip, 2 years after having my hip replaced, I developed AVN in my right shoulder and had to have it replaced. My left hip is showing signs of AVN, but has not collasped yet. I don’t know about all the causes, but I can say that the surgeries improved my quality of life. AND my knees have been “scoped” 5 times, but I think that’s just the arthritis associated with Lupus (and age).
Yesterday the doctor said that on top of the AvN, the reason for the recent increased pain is not because the hip ball has already collapsed, but it is very inflamed due to bumping it or something. Replacement surgery is definitely in the future, but probably in 6 months and not next week which is what I was thinking. I guess whenever the pain is not manageable anymore.
constantpeace: It’s pretty amazing what replacement surgery can do, isn’t it? Before the first hip replacement he was walking around like a question mark, and he was in so much pain. Nobody thought to x-ray his hips back then, either. We all thought it might be a hernia, or his knee, or his back. Finally it was diagnosed, and after the surgery he was a new man.
What happens when the hip replacement wears out? Do they go back in and adjust?
Avascular Necrosis ended Bo Jackson’s football career. I don’t know anything else about the condition, but it gives your husband something in common with arguably the greatest athlete ever.
meowmeow, the procedure for repairing a hip replacemnt is called Revision Total Hip Replacement. It’s a lot more complicated and risky than an initial replacement in that they have to take out the old replacement and the cement. They are supposedly not as “good” as the initial replacement . IANAD, this is from memory of the discussions with my surgeon years ago. There may be new techniques now. Try looking up Revision Total Hip Replacements.