Avascular Necrosis
Avascular Necrosis AIIMS PGI AIPGMEE
  • head of the femur is a common site of AVN.
  • Causes of avascular necrosis of femoral head
    • Idiopathic – commonest(MCQ)
    • Alcoholism
    • Steroid therapy
    • Sickle cell disease
    • Patient on renal dialysis
    • Patient on anti-cancer drugs
    • Post-partum necrosis
    • Goucher’s disease
    • Caisson’s disease
  • Diagnosis:
    • The disease is often bilateral (75%).  (MCQ)
    • Patient complains of pain in the groin or in front of the   thigh. (MCQ)
    • Pain is present at all times, but increases on exertion.
    • X-rays may be normal in early stage (MCQ)
    • if suspicion is strong, a bone scan may be done.
    • In later stage, an osteolytic lesion can be seen in supero-lateral part of the head (MCQ)
    • There maybe diffuse osteosclerosis of the head, but the shape of the head may be maintained.
    • In advanced stage, the head collapses (MCQ)
    • Eventually, changes of secondary osteoarthritisbecome apparent.
    • MRI scan is the best modality for early diagnosis of avascular necrosis.(MCQ)
  • Treatment:
    • Core decompression and fibular graftingis done if the head of the femur has not got deformed. (MCQ)
    • In later stages, once the head gets deformed, muscle-pedicle bone grafting using tensor facialata has been shown to produce good results  (MCQ)
    • In some cases with involvement of a part of the head, an inter-trochantric osteotomy has been described.
    • In cases with changes of advanced osteoarthritis, total hip replacement becomes necessary. (MCQ)
avascular necrosis
avascular necrosis

Femur head showing a flap of cartilage (osteochondritisdissecans) due to avascular necrosis

avascular necrosis
avascular necrosis

Front X-ray of right knee of an adolescent (epiphyseal plates are open): arrows point to avascular necrosis and developing osteochondritisdissecans in the outer medial condyle of femur

avascular necrosis
avascular necrosis

Radiography of total avascular necrosis of right humeral head. Woman of 81 years old with diabetes of long evolution

avascular necrosis
avascular necrosis

Radiography of avascular necrosis of left femoral head. Man of 45 years old with AIDS.

avascular necrosis
avascular necrosis

Nuclear magnetic resonance of avascular necrosis of left femoral head. Man of 45 years old with AIDS

Avascular necrosis for AIPGMEE AIIMS JIPMER DNB CET PG Medical coaching by DrMuraliBharadwajwww.onlinembbs.com

Avascular Necrosis, Blood Supply Femoral Head- Everything You Need To Know – Dr. Nabil Ebraheim

Treatment of Avascular Necrosis of hip by DrshrishDutt

Avascular Necrosis and Minimally Invasive Treatment Using Stem Cells – Mayo Clinic

Dr. Carlo Oller, emergency physician, talks about avascular necrosis

Avascular necrosis is an ischemic change (loss of blood supply) that occurs in a portion of bone. This may be traumatic or non-traumatic and may occur in multiple areas, mostly commonly affecting the hip, knee, shoulder, and wrist.

Avascular necrosis of head of femur results in sclerotic band formation in hip joint. Patient feels pain while walking in hip and inner part of thigh

Talus fracture ,Avascular Necrosis, Blood Supply – Everything You Need To Know – Dr. Nabil Ebraheim

Hip replacement for avascular necrosis is a successful operation .
there are various implants available.
the best,in our opinion ,is uncemented ceramic on vitE poly

Avascular necrosis stem cell therapy in Mumbai
This video explores the patient’s condition before and after treatment.It is published by StemRx India.

Betsy Skiles: Right Hip Replacement Due to Avascular Necrosis
Betsy Skiles, CSMO patient, was just 41 when she had to have her right hip replaced due to avascular necrosis. Drs. Jason Robertson and Matt Bernard worked together to get Betsy back to her active lifestyle.

Avascular necrosis treatment with bone marrow stem cells.ALAMPALLAM VENKATACHALAM
Avascular necrosis treatment with stem cells from bone marrow

“What Causes Avascular Necrosis?” featuring Dr. Sculco (ArthritisMD)
“For probably half of the patients who have it, we don’t have a specific cause.” Doctor Thomas P. Sculco, Surgeon-in-Chief at the Hospital for Special Surgery in New York, notes the many causes of avascular necrosis what also admits that they still have much to learn about the causes.