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Suggest Treatment For Avascular Necrosis
Question: Impression:Finding are suggestive of:-
I amXXXX XXXXXXX my age is 31 yrs onlyKindly suggest me teatment for below symtoms of AVN.
.Abnormal signal intensity involving bilateral femoral head ,neck and intertrochaneric region appear heterogeneouslyhyperintense on T2/STIR images and predominantlyhypointense on T1W image suggestive of bilateral avascular necrosis with class c lesion i.e. osteonecrosis focus signal analogous of fluid/edema.
.Subchondral area of increasedsignal in the medical aspect of left femoral head? Subchondral fracture.Outline of bilateral femoral head is grossly normal with no evidence of obious collapse or deformity of head.
.Mild bilateral hip joint effusion.
I amXXXX XXXXXXX my age is 31 yrs onlyKindly suggest me teatment for below symtoms of AVN.
.Abnormal signal intensity involving bilateral femoral head ,neck and intertrochaneric region appear heterogeneouslyhyperintense on T2/STIR images and predominantlyhypointense on T1W image suggestive of bilateral avascular necrosis with class c lesion i.e. osteonecrosis focus signal analogous of fluid/edema.
.Subchondral area of increasedsignal in the medical aspect of left femoral head? Subchondral fracture.Outline of bilateral femoral head is grossly normal with no evidence of obious collapse or deformity of head.
.Mild bilateral hip joint effusion.
Brief Answer:
Answer maybe Total Hip Replacement (THR)
Detailed Answer:
Hi, XXXX XXXXXXX
Welcome to healthcare magic.
I'm Dr. Sudhir Kumar
After going through your query I think you may go for THR Left side and Right side muscle pedicle graft.
But I need more details about your symptoms so that I am better able to help you.
I want to know how much painful hips are? On a scale of 1 to 10, if 10 is the worst pain, where would you grade the pain?
Whether you have difficulty in walking?
Please provide answer to these questions and any other details that maybe relevant to the topic and I will answer your query in detail.
Waiting for your reply
Dr Sudhir
Answer maybe Total Hip Replacement (THR)
Detailed Answer:
Hi, XXXX XXXXXXX
Welcome to healthcare magic.
I'm Dr. Sudhir Kumar
After going through your query I think you may go for THR Left side and Right side muscle pedicle graft.
But I need more details about your symptoms so that I am better able to help you.
I want to know how much painful hips are? On a scale of 1 to 10, if 10 is the worst pain, where would you grade the pain?
Whether you have difficulty in walking?
Please provide answer to these questions and any other details that maybe relevant to the topic and I will answer your query in detail.
Waiting for your reply
Dr Sudhir
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
I do not have problem in wakling.Some times feel pain in Knee in both legs and thies.Plz suggest medicines for recovery.
Brief Answer:
Aviod(delay) total hip replacement.
Detailed Answer:
Hi, XXXX XXXXXXX
Welcome back.
I'm Dr. Sudhir Kumar,
After going through your query, I think you should avoid (delay as far as possible) total hip replacement as you have little symptoms. You have mentioned that you some times feel pain in Knee in both legs and thighs. So you can take analgesics such as diclofenac slow release tablets whenever you feel pain. As your age is only 31 years so total hip replacement should be delayed as far as possible. You should reduce weight a little so that your symptoms also reduce further.
In my opinion, core decompression operations on both sides will be helpful to you. It will reduce progression of disease and further collapse (damage) of head of femur. In this operation multiple drill holes are made in femoral head to increase its blood supply. It is a relatively minor procedure. On left side it can be combined with muscle pedicle graft operation which is major procedure.
Other option is vascularised fibular grafting operation which is major procedure than above two.
But you are more interested in medicines. I want to say that medicines have little role.
In my opinion following medicine may be of help.
1.Alendronate(Bisphosphenates)which reduces bone breakdown and prevent collapse.
2.Glucosamine sulfate promote cartilage regeneration.
3.Diacerine it slows cartilage breakdown.
4.Analgesics whenever you have pain.
5.Vitamine D3 supplementation weekly (if its level is low)
All these medicines can be combined.
Hope I have answered your query. If you have any further questions I will be happy to help. If you do not have any clarifications, you can close the discussion and rate the answer.
Wishing your husband good health.
Take care.
Aviod(delay) total hip replacement.
Detailed Answer:
Hi, XXXX XXXXXXX
Welcome back.
I'm Dr. Sudhir Kumar,
After going through your query, I think you should avoid (delay as far as possible) total hip replacement as you have little symptoms. You have mentioned that you some times feel pain in Knee in both legs and thighs. So you can take analgesics such as diclofenac slow release tablets whenever you feel pain. As your age is only 31 years so total hip replacement should be delayed as far as possible. You should reduce weight a little so that your symptoms also reduce further.
In my opinion, core decompression operations on both sides will be helpful to you. It will reduce progression of disease and further collapse (damage) of head of femur. In this operation multiple drill holes are made in femoral head to increase its blood supply. It is a relatively minor procedure. On left side it can be combined with muscle pedicle graft operation which is major procedure.
Other option is vascularised fibular grafting operation which is major procedure than above two.
But you are more interested in medicines. I want to say that medicines have little role.
In my opinion following medicine may be of help.
1.Alendronate(Bisphosphenates)which reduces bone breakdown and prevent collapse.
2.Glucosamine sulfate promote cartilage regeneration.
3.Diacerine it slows cartilage breakdown.
4.Analgesics whenever you have pain.
5.Vitamine D3 supplementation weekly (if its level is low)
All these medicines can be combined.
Hope I have answered your query. If you have any further questions I will be happy to help. If you do not have any clarifications, you can close the discussion and rate the answer.
Wishing your husband good health.
Take care.
Note: For further queries, consult a joint and bone specialist, an Orthopaedic surgeon. Book a Call now.
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
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