What is Avascular Necrosis (AVN)? | Why does it happen? Who gets it? How do you diagnose it?
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- Опубліковано 29 чер 2024
- In this tutorial on Avascular Necrosis we will take you through avascular necrosis, explaining what this condition is, outlining some key causes and use 3D anatomy models to help explain why this condition is important in practice.
We hope you find this video useful for your learning!
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I didn't think about it 2 days ago when finally seeing an orthopedic surgeon. I had a very bad fall several months prior to the ungodly pain pain I've been in for almost 6 months. The new Dr had more x-rays before I left and they called me the same day to let me know my surgery date has been moved up. The Dr had already told me that my hip was destroyed! After the newer x-rays we seen, it's much worse than the Dec 2022 x-rays. Prayers are appreciated 🙏. I hope to have a speedy recovery 😊
So how is your life now after hip replacement? Are you able to do all sort of activities like running, jogging, hiking etc?
I was diagnosed with this at 29 years old. The doc said it was idiopathic but i do still believe it may have been caused by alcohol abuse and whatever shit medications and steroids they gave me in my 20's for various diagnosis's. Nonetheless my hips rotted completely in an 18 month span and i had both hips THR'd 7 months apart. My doctor at UB Orthopedics in Buffalo Robert McGrath, saved my life tbh. From the complete and utter misery to being 90% pain free after anterior hip replacements on both. It sucks knowing i will likely need a revision and i just try to be smart with my body to prolong them. Still plenty active and back to enjoying my life again. I have now had them for 9 years and im going strong! For ANYONE out there dealing with this, you are not alone and my thoughts and prayers are with you! STAY STRONG, One Love - C
Thank you so much for sharing your story, and more than anything, wishing you all the very best in the future 🙏🏼
Hey what lifestyle choices in or supplements or any activities have you tried to manage the pain? I am happy to hear you had positive outcomes from your doctor. Many people seem to suffer with this and pain medication without knowing exactly what went wrong for many years.
I have a friend who was just diagnosed. He is now and has been for the last 20+ years, a severe alcoholic. He is happy to have the diagnosis but is not willing to do anything about it. I will send this to him. Thanks for the information.
Is there new information about AVN spreading from joint to joint such as hip to knees.
Thank-you for this video. I'm going to show it to my doctor. I hope he finally learns something.
Wishing you all the best
Amazing! Thank you so much for this video
Sophie! How are you? You are always welcome, thank you so much for watching
This is one of the best videos that I have seen on this subject. I had a femoral neck fracture on May 5, 2022 and an ORIF the following day. Everything seemed to be going well with no pain and only minimal stiffness after sitting up until the 3 month mark. The stiffness got worse and the pain has returned and is getting worse each week. Mobility is an issue, and there are some days I can barely walk. I had a MRI last week, and will find out the results when I see my orthopedic doctor on Tuesday. I'm hoping that the three titanium screws don't obscure the radiologist's ability to properly diagnose the problem. Thank you for this video!
9b
Good luck sending healing love n liight your way 🫂💖🌟
How is your recovery? I had similar injury and mostly recovered by still worrying about AVN since it can occur long after the initial injury.
Great video! I was diagnosed with scfe in 2016 which led to AVN and then a total hip replacement bit if a rough few years but looking up videos of the condition really helps and is really interesting to read about as well!
🙏🏼 Hope you are doing well!
I was diagnosed with this after I had chemo therapy, i was a pretty heavy drinker as well but I never had any pain in my hips until I started chemo and taking dexamethasone, I have now had both my hips replaced and doing physiotherapy. avn made it really hard for me to walk and have and I was unable to return to work after my chemo because of it. I am hoping that I will be able to return to work sometime this year, I work in construction.
Thank you so much 🤩
You’re very welcome! Thank you so much for watching!
Nice explanation 👍
Thank you so much! So glad you enjoyed it!
Yep. I've been looking for this info for a long time. Finally I know what the legemnetum teres is and why i have avn now. Okay well this sucks, was totally hoping I could get by without a hip replacement but my legemnetum teres is messed up....and has been for awhile.
Wishing you all the best my friend
Just got diagnosed a few mi utes ago. Thanks for the vid.
🙏🏼
How did u get this
What can be done after diagnosis? I think I am at the onset of this AVN due to sickle cell disease. What do I do so I don't lose mobility
Currently im 27. I was diagnosed with AVN almost 3 years ago. I have been putting off surgery as long as I can but the pain at times is unbearable and i feel im getting close to not being able to avoid surgery. Has anyone else gotten total hip replacement at this age & how is your quality of life after?
I had total hip replacement 3 years ago...man life is great now,pain free,no limp when I walk..you won't regret the surgery
Did u do total hip replacement?
Can u do physical exercise?
May I ask what the pain is like ? If you had to describe it ? When it is worse etc?
How about elhers danlos syndrome? I was born with severe hip dysplasia and i sublux the joint all the time.
I've been in intense pain being on my leg and lifting heavy things up and down stairs for months in which time a chiropractor told me was my lower back was swollen and pinching my sciatic nerve. I stopped going to him because he said he thought he "fixed it" the last 3 times i went when the visits lasted 2 minutes and it wasn't helping. I went to the Er today because i couldn't sleep because of uncomfortability and unable to walk when i got to work at a job where I'm on my feet for anywhere from 10 to 12 hours. They took x-rays and immediately diagnosed me with this. I'm 41. I'm just beginning a journey of opinions of what the root cause is
So sorry to hear this sir, wishing you all the very best
Have your doc look into covid. Especially if you had it and was given steroids. I am going through this now!
- I was also misdiagnosed by my primary physician. I worked in severe pain for almost 6 months before I went to the ER and the next day an orthopedic specialist. The doctor told me I needed total hip replacement. I am 50 years-old.
Can pysiotherapy help if i have got capitellar avn after communited dislocated fracture of elbow humerus fracture?
So sorry to hear this has happened to you - physiotherapy may be able to help you with regaining movement, but it is likely that the medical/orthopaedic team would need to manage the AVN itself
@@ClinicalPhysio Still now my elbow is not getting opening fully. 2 weeks of home pysio on own, 1 month traditional pysio under an experienced phsio, and 15 days of pysio at a center with equipments is done. It is taking so long.
I was diagnosed in 2014. Might eventually get a hip replacement surgery soon. I don’t know my fate yet. In the mean time, what can I do to improve it?
I just got diagnosed with this today 2 years after I had displaced femoral neck fracture. I guess I’m getting a new hip! But I would like to delay it as long as possible
Wishing you all the best 🙏🏼
why delay? the older you get, the more risk of dementia or delirium from general anesthesia. If you need it anyway, why not feel better sooner? Plus rehab is easier the younger you are. Just make sure to be an advocate for yourself in the hip rehab process, if they drop the ball on physical therapy post op you can end up in a wheelchair...you need physio asap after the surgery. Good luck whatever you choose.
My mom is 64 and she needs surgery but she’s afraid 😢she had a kidney transplant 12 years ago and she’s overweight
so was surgery done?
I had hip displacement when I was baby. Doc basically broke hips and set them in place in 1976. Fast forward to now I'm 47 I can barely walk. Hips and knees are bad. I try to loose weight and can't. I'm waiting on scans soon. Anxious to get it looked at.
Ive just been diagnosed with this. I had to get a private MRI as my GP sucks. I have a history if chronic alcohol misuse. I think this is the cause in my case. Even though my alcohol use has been cessated. Im looking to get a replacementbnow with the spire group of hospitals.
Wishing you all the very best Matthew 🙏🏼
They can help but you need scam . If you go private they get angry
I have AVN due to sickle cell I’ve had it over 14+ years I’m only 26 now. Been trying to avoid hip replacement but it’s now giving me problems again. Hopefully I can avoid it for several more years. Thanks for the video I wanted to refresh myself on it.
Wishing you all the very best!
What medication do you take to avoid the pain please?
I have AVN also but I can’t afford a surgery just yet
Do You also limp when you walk and limited joint movement on the hips and pain? Im 26 and ive had it for 2 yrs. Im on the late stage and doctor said hip replacement is the only cure.
Hey I have sickle cell too and was recently diagnosed with AVN as well right now I'm dealing with the pain as I was told it's in it's early stages and surgery can't be performed...What do you take to manage the pain to be honest I've been avoiding taking pain meds because of fear of addiction and rejection incase I get I to crisis.... please do reply I'd like to actively get to conversate with you 😊
Adequate rest helps. I have sickle sickle cell too. I’m a software engineer, sitting for long hours causes pain in my hips. I’ve been managing it since 2014. I’m trying to avoid a surgery as much as possible
I just got diagnosed with this. I'm 21 and honestly don't know what to do. I do have sickle cell anaemia
Wishing you all the very best 🙏🏼
Hello doctor, i need urgently to know if the utrogestan for pregnancy without the use of aspirine, may be the cause of blood dificulty flow in the joint. Im 8 months pregnant and i cant walk,im in bed resting very very dificulty. Pls may be the use of aspirine or other blood thiners to lifhten my pain in walking and even in resting, especially in the night. Im taking paracetamol for the pain 3 times a day until i give birth. Pls help
i was 60 y.o. male with atherosclerosis walking 15 miles a shift at A****n, when I suddenly got it, it felt like a groin pull but quickly worsened where I couldn't put any weight on it. The recovery was lengthy but range of motion of my hip is still compromised.
🙏🏼 wishing you all the best
I used to drink a lot and workout a lot, martial arts. Lots of wear and tear. I had to get a hip replacement. Not full blown AVN, but the right hip was worn out. I quit drinking years before, but it was too late. I later caught covid, which caused me to have to take a lot of steroids in the hospital. My left hip is now a mess.
So sorry to hear of your situation, wishing you all the very best
Would you risk practicing stairs / steps with someone with high BMI, bilateral hip AVN (from steroid use) where consultant reports femoral heads are "collapsing in the weight bearing quadrants"? 🧐
Can dynamic hip screw cause avn? Particularly if you have had intertrochanteric fracture ?
It may not necessarily be the screw that causes the AVN , it could be that the initial fracture itself is what contributes to the AVN
intertrochanteric fracture does not usually lead to AVN because it doesn't disrupt the blood vessel within the hip joint.
Hello Doctor, I have a question I hope you may be able to help me with. Since AVN of the hip is caused by a disruption in the blood supply to the femur head, should the blood vessels be studied and treated so there isn’t continual damage? AVN is a secondary disease it seems so should the primary blood flow issue be resolved then the bone issue addressed? I am due for a THR but I’ve complained of what I thought were bloodflow issues for 20 years and nothing was discovered. Recently I’ve been diagnosed with AVN. The deadened bone is being addressed but my concern are the blood vessels. Any advice is appreciated. Thank you
If you do THR, the whole femoral head is removed. No more blood vessel to talk about at all.
The problem is very complex because the blood vessels go to the femoral joint in many routes. I doubt any doctor performs artery repair within the joint capsule because the doctors have to cut through ligaments while trying not to move the femoral head. Maybe some day, stem cell therapy can be applied to this area to allow the bone to regrow tissues including blood vessels without turning it into a tumor first.
I am 43 and just got diagnosed couple of months ago. They recommend hip replacement but i've been trying to see if there are other options. I am in pain, limping but usially the pain doesn't exceed 5 on the scale of 10. There's definitely limited range of motion. I have been trying to figure out what could have caused this since i have never been on steroids, drink alcohol very moderately and always have, i smoked for 10 years but i wasn't a heavy smoker, usually couple cigs a day, i am not overweight and have pretty good diet... i was in car accident in 2003 and now i'm wondering something could have happened then. But it seems like a long time for it to develop. I totalled my car and was pretty bruised up on my legs but i didn't break anything and was pretty much ok after 3 days of not being able to move much. Do you think it could stem from that accident? I am just trying to figure it out. I don't want it to happen in my other hip as well.
Mine is from my car accident in 1997 I’m now needing a replacement n suffering from pain. So it could be from ur accident 🤔
@needtono8746 I am sorry that you're in pain! I hope you can get replacement soon!
I have all the hip symptoms. For me it started as hip ache for 12 months then pain, stiffness to knee literally within weeks, sleep, walking, bending all affected. Just had xray which is inconclusive. Mri booked for next week. Is that more likely to show avn.
Hi Ian, Yes MRI will hopefully be more conclusive- wish you all the best with it
its been over a year. what has happened?
I have sickle cell anemia and suffer from avascular necrosis of the right hip what are some treatments you would recommend
I have it due to steroids use pretty much my whole life due to asthma: I’m on crutches to help me walk and it still hurts like hell to move: my head has collapsed nothing they can do at this point but do a total hip replacement. I’m scheduled next month for one😣
Thank you for sharing I wish 🤞 you luck 💖 and always love in all your endeavors
@@Sephiroth_knight ❤️❤️
I was diagnose it plz help me out
I have it now at 21.. really sucks I need more time. I swear there is a way to heal it we just haven't figured it out yet
I hope you get better or a surgery, my son has it too, at 25. ❤
I think this disease is interesting because all theories of why it occurs vary between the people who discuss it. This guy is quick to blame alcohol. Most people are quick to blame steroids. Other people blame bone trauma cutting off the blood supply. In the end it's basically like cancer and if you get it you need a hip/shoulder replacement or you're in pain for the rest of your life because there is NO CURE.
I have MS and I’ve been on serious medication‘s some steroid all but not all for about 20 years I broke my shoulder in 2020 I never got proper therapy apparently and typical with our medical system there was never any follow up to make sure I was healing properly so when I went a year later they told me I had necrosis and I didn’t heal properly so now I guess I have to live with this forever.
Constant pain or I have to have shoulder surgery and because I have MS and a weak balance they would like to put me into a nursing home while I recover and it could take months up to six months or more.
I’m not going into a nursing home, rehab center I don’t trust the medical world enough for that PS I’m only 53 but I’ve lived with MS already for 20 years probably longer but diagnosed 20
Ps I never drink but sometimes wish I could
I was treated for 15 yrs with IV steroids, then after the Iv dose, an oral taper of Prednisone. They always started with 60mg and tapered down. The treatment for my MS, it caused my AVN of femur head & hips. I've never been a heavy drinker, I'd only have a few out monthly while dining.
I'm also experiencing issues with stiffness and deforming of my right hand, which has progressed worse the last few years.
Not one orthopedic gave me a number in which to rate my AVN, or even tried to save my bone before a collapse happens. I've been to four orthopedics, all in which just told me I do have the AVN. I have continuous pain in many places, especially my left groin, S.I. joints, cervical; rt fingers, hand & wrist.
I wonder how many other MS patients was diagnosed with AVN after long-term steroid usage/treatment ? We should place that question out on MS & social media sites, just to see how many more cases will be revealed from over usage of steroids. If patients are receiving continuous CNS MRI's yearly, or even bi-yearly, why isn't neurologists & PCP's catching AVN, and then putting a stop to the steroid use when the radiologist finds the first indication of osteonecrosis ? Shouldn't they be discussing the diagnosis & prognosis with their patients, leave it up to them for that final decision ? Nobody wants continuous broken bones, structural collapse, or hip replacements at an early age. Neurologists should stop the steroids when AVN is diagnosed, and try other methods of treatment, like IVIG. But yet,I know the price of the IVIG treatment is outrageous, isn't over 10 thousand a round of it ? Insurance and hospitals may not approve them. They should be required to, especially if you have AVN, and can't have no more treatments with steroids. Is there another form of treatment besides steroids & IVIG, to help take you out of an active exacerbation ?
@@kathleendonahue5955 It's horrible what doctors get away with. The patient suffers while the doctor gets paid.
@@lindasnowden2674 It's so sad what we go through. I've been dealing with this for many years. It just keeps getting worse.
Yes the pain is a nightmare found out in June that both my hips needed to be replaced the left was worst so they did it first and the right is going to be done at a later date. Point to make clear I never drank alcohol in my life 40 years old but was born with severe asthma and from birth until I was about 25 I was on lots of steroids and my Ortho surgery took one look at my history and new right away the cause
I have AVN first found in my right knee then my left shoulder and right hip. These joints have been replaced. After that it spread to my toes in the right foot. Few years later it’s now in my other hip and shoulder. It was all cars from the steroids. They gave me at the hospital. As a protocol for a brain tumor, which I had, which was with massive doses of cortical steroids, and I don’t even drink.
I'm so sorry this is happening to you I've been through similar things and i felt compelled to let you know you're not alone. Prayers going up for you and i will continue to pray for you hun, sending alot of healing love n liight your way 🫂💜💖🌟🫂
i"ve had 3 different Workers Comp md's tell me I have AVN, after having a traumatic injury at work. They all say this was not a work injury. I am baffled that they all diagnosed me with this after I told them i was 110 % strong before this injury. The way my upper body was pulled and twisted to the left of my body, while my lower legs and pelvic were pretty much grounded facing the opposite direction. They said my left is bad and their is a small percentage in my right formal head, which i believe I might have been crushed from my left to right, with my left getting all damage. It took about 1 and 1/2 months to feel a shooting and tingling run down my leg and off and on pain. Never understood this feeling. Then it moved to my groin area and what i considered my left butt cheek. Now it is getting worse, they said i need surgery. I am lost.
Oh, and by the way, I have none of those causes in the list, but trauma/injury. should i get a second opinion, from personal doctor who last saw me healthy for my age and strong.
So sorry to hear this has been going on for you - wishing you all the very best and hope for better days ahead
I had an xray of hip that showed numerous incidental phleboliths deep in pelvis.. about 10-15. Then hip pain the mri shows bursitis, tendonopathy of 2 tendons and possible labral tear.. can AVN contribute to the degeneration of these due to lack of blood flow to the areas resulting in AVN? Thanks .. my doctor laughed at me but he's not a very smart man
Hi Katie - it’s difficult to say on a case by case basis, but generally speaking it is most commonly bone and cartilage which are the structures affected rather than bursa/tendons
@@ClinicalPhysio ok gotcha, understood.
@@ClinicalPhysio and thank you much!
Is it possible that I experience Prostatitis like symptoms because of AVN condition? I am 24 years old and actually medical student, my father had both of his hips replaced recently because of AVN. I feel all of his symptoms and some prostatitis like symptoms. I was treated for Prostatitis for 2 years and now I am being treated for CPPS as I thought it might be psychosomatic but nothing helps at all. What is your opinion? Personally I have never heard or anyone around me for such case but it does make sense to have some connection. Thank you in advance!
Personally I haven’t heard of this connection, but if you are concerned the best advice I can give you is to get a full assessment from your Doctor to be sure
@@ClinicalPhysio thanks for the reply.
as a medical student you are probably unlikely to go too far outside the box for answers but since you are so young what do you have to lose by trying anything and everything? First, maybe it is somehow related to the concept in Quantum Physics of quantum entanglement...like when one twin experiences pain from a car accident but it is their twin that is actually in the accident. Or a mother feeling that her child died...Quantum Entanglement is a real thing in science proven only at the quantum level so far but it could be that you are somehow so connected to your dad that you are experiencing symptoms. Husbands have long reported pregnancy symptoms when their wife is pregnant. Next, and even more out there but also kinda fun and you never know, even Harvard researchers led programs using this as a treatment method - get a good past life regression. Why not, keep it a secret if you have to. But at your age, I'd try a freaking psychic, a shaman, DMT, anything to not have to deal with those kinds of problems from here on out. Hope it is something fixable for you!
I have AVN of femoral head.. It is second stage according to MRI report.I have very little pain.Is it be cured without surgery?
Rush before it gets to stage 3 and 4, stage 1 and 2 are the best to manage this problem. I delayed and it has not healed well 2yrs down the line. Rush for treatment before it's too late. I had core decompression surgery.
@@annewamaitha1488 can u share ur number
@@annewamaitha1488 how do you feel after the decompression? I was diagnosed with AVN stage 2 last week.
@@nikhilmineIt will be 3 years since core decompression
Surgery . There is great improvement, with little limp and less pain. I have restricted weight lifting and aggressive bending, runnning and such. I thank God for healing me.
Does avn make the joint appear larger?
Not necessarily if joint is deep like the hip
👍👍
Thank you!
Chemo induced as well.
Yes! Very true!
I personally don't think they know or want to state the full extent of what is causing AVN. Im almost positive the medication we receive are a major factor as to who develops AVN. Lets not blame the pharmaceutical industry. They donate money to our studies and hospitals.
Why do some people have a stagnant stage of AVN all their life and do not require a hip replacement?
I suppose this will all depend on the extent of the pathology, and the factors that contributed to the AVN in the first place which may have improved or been eradicated
Hello do you have avn ?
@@tcd361 hi! I do not
@@tcd361 yes, I have/had stage 3. Gone through Ayurveda treatment and am much better now..
@@saurishroy781 good bhai , shockwave therapy also cure avn ,my two friends got cure from shockwave therapy
I hope I don’t have it 😢 30th January I have an MRI appointment. Wish me the best, I’m still 17 and my life would be broken if I know I can’t be sportive anymore
Wishing you all the best 🙏🏼
Yesterday I got my mri and doctor told avn it is and I'm still 27 ..he said use of steroids in COVID caused this
2:10
🙏🏼
I have my avn after my chemo they said it was because of the steroids I received after my chemo
So sorry to hear this, sending best wishes to you