AVN Hip Prognosis UPDATE: #2
Posted by S.J. Owens | | Posted On Monday, July 26, 2010 at 12:53 PM
OK, so after 2 months of heavy R&D on AVN and several Doctors visits, it was time to find someone who could give me a "second - second" opinion and some clinical clear answers to what is happening to me and what I need to do. Enter Dr. Chimento, Orthopedic Surgeon at Ochsner Hospital; had a good appointment with him this morning and the good news is that I should not need THR (Total Hip Replacement), at least not now in this still early stage of my life. He is convinced that the best approach for me is a procedure called CD (Core Decompression).
CD procedure involves drilling a small hole in the diseased bone. It was developed by Arlet and Ficat in 1964. Stage-2 AVN, what I have, means that there is pressure within the diseased bone from a lack of blood flow to that region which causes the bone to die. This increase in pressure is associated with pain which in some patients becomes intolerable. CD relieves the pressure from within this rigid structure. The drill hole then fills with tissue and, in some cases, new bone forms within this area. It may increase the blood flow to the diseased area of bone and allow new blood vessels to form. The procedure appears to slow down the disease process in most cases and may even stop its progression in others. One of the features of a CD is that it does not limit further surgical treatment should the disease progress. It is a relatively simple procedure and recovery from it is fairly quick. Pain relief occurs rapidly.
So now it is a waiting game. I will see Dr. Chimento again in 3-months at which time he will order additional X-rays be done, if no change, we will proceed with making a date for Core Decompression Surgery. See illustration below of CD procedure... Fun.... NOT!
CD procedure involves drilling a small hole in the diseased bone. It was developed by Arlet and Ficat in 1964. Stage-2 AVN, what I have, means that there is pressure within the diseased bone from a lack of blood flow to that region which causes the bone to die. This increase in pressure is associated with pain which in some patients becomes intolerable. CD relieves the pressure from within this rigid structure. The drill hole then fills with tissue and, in some cases, new bone forms within this area. It may increase the blood flow to the diseased area of bone and allow new blood vessels to form. The procedure appears to slow down the disease process in most cases and may even stop its progression in others. One of the features of a CD is that it does not limit further surgical treatment should the disease progress. It is a relatively simple procedure and recovery from it is fairly quick. Pain relief occurs rapidly.
So now it is a waiting game. I will see Dr. Chimento again in 3-months at which time he will order additional X-rays be done, if no change, we will proceed with making a date for Core Decompression Surgery. See illustration below of CD procedure... Fun.... NOT!
Glad to hear you have other options. Good luck at your next appointment!
Um, I'm looking at having this procedure, just found out today that I should consider this rather than a double THR done. Have you had the procedure? Did it work? How was the pain post surgery?
I'm 38, and was diagnosed with Avascular Necrosis, the R hip is worse than the left, but obviously needs repairing.
rick73,
I am 38 as well, was 37 when I had the THR done. At what stages is the AVN in each hip? Depending on the Stage, Core Decompression may not be an option. My left hip was worse than my right so we opted for a THR due to the fact that my AVN was in a borderline Stage 3-4; no CD would have helped me at that point. Within two weeks I progressed from a walker, to a cane, and finally to not needing either. I had a total of 6 months of Therapy which helped a great deal. I currently only have slight issue with discomfort to the muscle itself with some numbing in my thigh, in which I may never get the feelings back, etc. The hip itself does not hurt, pain free, just the muscle needs to be stretched and worked out mildly every so often. The more you do the better it feels. Send me your email address as I would be happy to chat further on this issue.