What are the 4 stages of avascular necrosis?

Stage 1 has a normal x-rays but MRI reveals the dead bone. Stage 2 can be seen on regular x-ray but there is no collapse of the femoral ball. Stage 3 shows signs of collapse (called a crescent sign) on x-ray. Stage 4 has collapse on x-ray and signs of cartilage damage (osteoarthritis).

What is a Ficat classification?

The Ficat and Arlet classification uses a combination of plain radiographs, MRI, and clinical features to stage avascular necrosis of the femoral head.

What is Ficat stage3?

Ficat classification of the four radiographic stages of hip osteonecrosis. Stage I = normal radiographic appearance. Stage II = transition phase. Stage III = sequestrum with subchondral collapse. Stage IV = decreased joint space and collapse of the femoral head.

What is Stage II avascular necrosis?

Stage II is characterized by cystic and sclerotic changes observed in the femoral head on a plain radiograph. In Stages III through VI, the radiographic signs of progressive worsening of osteonecrosis of the femoral head are seen.

What is Kerboul angle?

The Kerboul angle is the sum of the angles formed by the extent of femoral head lesion and the center of femoral head on anteroposterior (A) and lateral (B) radiographs of hip.

What causes avascular necrosis?

Avascular necrosis occurs when blood flow to a bone is interrupted or reduced. Reduced blood supply can be caused by: Joint or bone trauma. An injury, such as a dislocated joint, might damage nearby blood vessels.

Can AVN of hip heal itself?

Is there a cure for avascular necrosis? Treatment can slow the progress of avascular necrosis, but there is no cure. Most people who have avascular necrosis eventually have surgery, including joint replacement. People who have avascular necrosis can also develop severe osteoarthritis.

What is core decompression?

Core Decompression. In core decompression, a surgeon uses a drill to remove diseased tissue from the inside of the bone affected by osteonecrosis. This procedure relieves pressure within the bone, increasing blood flow and allowing new blood vessels to form.

How is avascular necrosis of the femoral head treated?

In early stages of AVN (precollapse), core decompression with or without bone graft is typically considered the most appropriate treatment. In late stages, characterized by collapse, femoral head deformity, and secondary osteoarthritis, total hip arthroplasty is the most appropriate treatment.

What is avascular necrosis of femur?

Avascular necrosis of the femoral head is a type of osteonecrosis due to disruption of blood supply to the proximal femur. There are approximately 10000 to 20000 new cases reported each year in the United States alone. [1] It can occur due to a variety of causes, either traumatic or atraumatic in origin.

What is the best treatment for avascular necrosis?

The options include:
  • Core decompression. A surgeon removes part of the inner layer of bone. …
  • Bone transplant (graft). This procedure can help strengthen the area of bone affected by avascular necrosis. …
  • Bone reshaping (osteotomy). …
  • Joint replacement. …
  • Regenerative medicine treatment.

Can AVN be treated without surgery?

The use of stem cells in treating AVN is a promising minimally-invasive, non-surgical treatment option to halt the progression of the disease and heal the dead tissue. Stem cell therapy for avascular necrosis helps to avoid total hip arthroplasty surgery.

Can core decompression reverse AVN?

Core decompression procedure, when done in the initial stages, before collapse, may arrest or reverse the progress of avascular necrosis and thereby may preserve the normal femoral head.

Can you live a normal life with AVN?

Because of these complications, the affected person has to slowly, and very painfully, endure the joint collapse and withstand the pain and loss of mobility as long as possible before undergoing the first joint replacement. This is no way to live.

What is the most common cause of avascular necrosis of the hip?

Avascular necrosis is a disease that results from the temporary or permanent loss of blood supply to the bone. It happens most commonly in the ends of a long bone. Avascular necrosis may be the result of injury, use of medicines, or alcohol. Symptoms may include joint pain and limited range of motion.

Can dead bone regenerate?

Osteonecrosis, or avascular necrosis, occurs due to compromise in blood circulation. Without concurrent neovascularization, the consolidation or regeneration of bones cannot be sustained.

Can AVN progression be stopped?

Core decompression of the head of the femur along with stem cell therapy, has shown the potential to stop the progression in the early stages of the disease. Unfortunately, many patients still progress to advanced stages of avascular necrosis, requiring joint replacement surgery.

How fast does AVN progress?

AVN can progress through these stages quite rapidly over a period of just a few months or it may take 12 – 18 months. This is in contrast to osteoarthritis of the hip which is a generally slowly progressive condition that takes years to develop.

Can exercise help AVN?

Exercise

Exercise or physical activity that doesn’t involve putting weight through the hip joint is recommended, particularly for those that are in more advanced stages of AVN. Hydrotherapy, with its warm and buoyant properties can provide relief to the area as well as improved range of motion (movement) (2).

What happens if AVN goes untreated?

Avascular necrosis (AVN) is the death of bone tissue due to a loss of blood supply. You might also hear it called osteonecrosis, aseptic necrosis, or ischemic bone necrosis. If it isn’t treated, AVN can cause the bone to collapse. AVN most often affects your hip.

What is the recovery time for avascular necrosis surgery?

This surgery reshapes the bone to reduce stress on the joint. Doctors use it when you have a small area of affected bone. Recovery takes anywhere from 3 to 12 months.

How long does avascular necrosis last?

Recovery takes about eight weeks. If left untreated, AVN progresses and results in pain and severe osteoarthritis. Treatment decisions for AVN are ultimately up to the patient and are based on his or her lifestyle and goals.