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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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    What is avascular necrosis and how is it treated?

What is avascular necrosis and how is it treated? I recently has an X-ray of my rt. hip that only showed minor arthritis change in my hip. I am 60 yrs old female. I also have rt thigh pain and rt. abdomen pain/soreness heat does provide relief. with increased activity my thigh and rt. hip pain increase causing me to limp. My doctor recently treated me with methylpredisolone tablets 4 mg. for a week that really helps with the pain and soreness, After the medications was gone the pain and soreness started to come back. I hope that you can help me to understand what is going on. Thank you.
Thu, 10 Mar 2016
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Orthopaedic Surgeon 's  Response
hi
Avascular necrosis is devascularization of femoral head (loss in blood supply), this causes bone part to become necrosed (dead) and becomes suseptible to fracture collapse eventually, when partially necrosed, it is very painful on weight bearing or walking. Xray shows it as denser area than surrounding or adjacent bone.Once the blood supply is impaired , complete necrosis follows in 6 months to 2 years.So salvage operations are done with prosthetic implants or weightshifting surgery.I hope your doctor has confirmed if it is indeed avascular necrosis.Arthritis is different, in hip, it doesnt lead to avascular necrosis but destruction of joint surfaces and deshaping of joint in later stages.We must be clear whether it is arthritis only or avascular necrosis as treatment varies.Its best to leave it to your orthopedic or hip surgeon to decide diagnosis and treatment.Yes, as you are advised physical therapy it maybe just arthritis, which is more readily manageble conservatively, unlike avasculr necrosis which requires surgery more frequently
best wishes
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