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Avascular necrosis of bone or ischemic bone necrosis

Definition

Avascular necrosis of bone or ischemic bone necrosis (AVN) There is cellular death (necrosis) of bone due to interruption of the blood supply. There is bone collapses. If avascular necrosis involves the bones of a joint, it often leads to destruction of the joint articular surfaces.

Causes

Risk factors:

Alcoholism Excessive steroid use Post trauma Caisson disease (decompression sickness) Vascular compression Hypertension, vasculitis Arterial embolism and thrombosis Damage from radiation Sickle cell anaemia Gaucher's Disease Deep diving Idiopathic (no cause is found) Rheumatoid arthritis Lupus Repeated exposure to high pressures (as experienced by commercial and military divers)

Cell death and repair The hematopoietic cells ( present in bone marrow which produces all cells in the blood like RBC,WBC etc.) are most sensitive to anoxia and are the first to die after reduction or removal of the blood supply, usually within 12 hours. Then bone cells (osteocytes, osteoclasts, osteoblasts etc.) die within 12-48 hours, and that bone marrow fat cells die within 5 days.

Symptoms of Avascular necrosis of bone or ischemic bone necrosis

Avascular necrosis usually affects people between 30 and 50 years of age While it can affect any bone, and half of cases show multiple sites of damage, avascular necrosis primarily affects the joints at the shoulder, knee, and hip. Commonly affects the ends (epiphysis) of long bones such as the femur (the bone extending from the knee joint to the hip joint). Other common sites are Humerus (the bone of the upper arm). Knees Shoulders Ankles Jaw

Homeopathic treatment for Avascular necrosis of bone or ischemic bone necrosis

Avascular necrosis is especially common in the hip joint. Total hip replacement is the treatment plan mostly.

A new, more promising treatment is hip resurfacing or metal on metal (MOM) resurfacing.

Other treatments include core decompression, where internal bone pressure is relieved by drilling a hole into the bone, and a living bone chip and an electrical device to stimulate new vascular growth are implanted; and the free vascular fibular graft (FVFG), in which a portion of the fibula, along with its blood supply, is removed and transplanted into the femoral head.

Prognosis



The amount of disability that results from avascular necrosis depends on what part of the bone is affected

Normally, bone continuously breaks down and rebuilds old bone is reabsorbed and replaced with new bone. The process keeps the skeleton strong and helps it to maintain a balance of minerals.

In the course of avascular necrosis, however, the healing process is usually ineffective and the bone tissues break down faster than the body can repair them. If left untreated, the disease progresses, the bone collapses, and the joint surface breaks down, leading to pain and arthritis.

Homeopathic treatment:

As per the underlying diagnosis of the condition, homeopathy offers the line of management. Usually if there are anatomical changes, there is only palliative help from homeopathy side.

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