Osteonecrosis is a serious condition that can eventually require a joint replacement. Learn how proper preventative care can reduce your chances of developing osteonecrosis.
What is Osteonecrosis?
Osteonecrosis is a painful deterioration of the bone that can cause arthritis and severe pain. When osteonecrosis occurs, tissue begins to die, leading to arthritis damage and collapse of the bone in the area.
Osteonecrosis most commonly occurs in the hip joint, where the head of the thigh bone (the femur) no longer gets enough blood to stay healthy. Less common areas that can be affected by osteonecrosis include the knee and shoulder joints.
What Causes Osteonecrosis?
In many cases, osteonecrosis is brought on by trauma to the joint. There are several health issues and injuries that can lead to osteonecrosis, including broken bones, lack of circulation due to disease, alcoholism, excessive use of corticosteroids, lupus, sickle cell anemia, HIV, radiation therapy, and organ transplants. Most people who develop osteonecrosis are between the ages of 20 and 50.
Symptoms of Osteonecrosis
Noticeable symptoms are not common in the earliest stages of osteonecrosis. As it progresses, however, your affected joint may hurt when you put weight on it. Later on, you will feel pain when you are lying down and when you are sitting. The pain will develop gradually from mild to severe, starting as a dull ache and becoming worse over time. Pain from osteonecrosis can be felt in the joint itself or it may migrate. For example, hip osteonecrosis may be felt in the buttock, thigh, or groin area.
Ways to Prevent Osteonecrosis
There are a few ways to prevent osteonecrosis. The primary focus should be on preventing damage to your bones and keeping them healthy so that you do not sustain blood loss to the area.
One way to prevent osteonecrosis is to avoid smoking. Smoking reduces overall blood flow to the bones and weakens them. Smoking also leads to osteoporosis, which can contribute to osteonecrosis. Controlling your alcohol intake can also help reduce your risk.
Take Safety Precautions
Take every precaution when taking part in sports or other activities that could lead to repetitive injuries or breaks in your joints, especially your hip. A broken femur may heal poorly and lead to insufficient blood flow in the joint, causing eventual bone deterioration and tissue death. The resulting osteonecrosis may lead to severe pain and the inability of the joint to support your weight or function properly.
If you do break a bone, particularly any bone involving a joint, make sure it is adequately immobilized and monitored carefully during the healing process. Once the cast or brace is removed, physical therapy may be recommended to ensure that the bone and joint are functioning correctly and to encourage proper blood flow to the area.
Limit Steroid Use
If you use corticosteroids such as prednisone to treat chronic or recurring conditions, work closely with your doctor to ensure you are using these medications for the shortest amount of time possible in the lowest reasonable dose. Balancing your symptoms against side effects can be difficult, but monitoring your bone health through the use of x-rays and other imaging techniques will help.
Treatment Options for Osteonecrosis
There are surgical treatment options for osteonecrosis, including:
Decompression helps improve blood flow in the joint by surgically relieving pressure. In a hip decompression, for example, small holes are drilled into the femoral bone while you are sedated. This procedure is usually effective only during the earliest stages of osteonecrosis.
Vascular Bone Graft
In a vascular bone graft, healthy bone and blood vessels from another part of your body are surgically implanted into the area affected by osteonecrosis to stimulate blood flow. This procedure is most effective during the earlier stages of osteonecrosis before any significant damage has taken place.
Joint replacement is an effective way to treat osteonecrosis; however, not all patients are candidates for joint replacement surgery. A less invasive option for some patients may be joint resurfacing, which involves altering parts of the joint instead of replacing them.
If you have symptoms of osteonecrosis, including pain in a specific joint that is more severe when you apply weight to the area, contact Arkansas Surgical Hospital at (877) 891-9322. You can also request an appointment on our website to discuss your options with one of our orthopedic surgeons.