Doctor insights on:
Osteonecrosis Femeral Head
My 67 years old mom has onfh (osteonecrosis of the femeral head) on both hip joints, what's success rate on surgery to replace total hip in her age?
Very high: Rates depend on what you are defining as success. Hip replacement is more than 90% successful in reducing or eliminating pain. Depending on your mother's activity level and desired activities, some changes may need to be made but her orthopedic surgeon could talk to her about this before the surgery and be more specific. ...Read more
Aseptic necrosis is also called osteonecrosis, avascular necrosis (AVN), or ischemic bone necrosis. It is a condition that occurs when there is diminished blood to the bone. An interruption to the blood supply causes bone to die. If the environment is not altered or improved, the involved bone may eventually collapse and ...Read more
My mom has onfh (osteonecrosis of the femeral head) on both hip joints, and she is 67 years old, is surgery necessary? What's risk? How effectiveness?
Osteonecrosis: Surgery is only indicated if he is having hip pain that is effecting her quality of life or ability to function. Most common surgery would be a total hip replacement where both the femoral head and the acetabular cup are replaced. This surgery has the highest patient satisfaction rate of any surgery done by orthopedic surgeons. ...Read more
My 67 years old mom has onfh (osteonecrosis of the femeral head) on both hip joints, what are the risks on surgery to replace total hip?
Statistics: Every center where this procedure is performed will provide you with statistics (so you can compare) of the adverse outcomes and inform you of risks involved in this particular case. In general bleeding, anesthesia misshaps, residual pain, etc are common risks of surgery of this type. Consult your dr, good luck! ...Read more
My 67y mom has osteonecrosis of the femeral head on both hip joints, she could walk with chair but pain, what could happen in the future if no surgery?
Get worse and bed --:
Ridden or in a wheelchair, as severe arthritis would result. The only way is one or the other type of surgery. At her age, depending upon the severity of her avn, total joint replacement might a better option as in one surgery she'll get rid of all problems.
Get her seen by an orthopod.
Good luck and happy holidays. ...Read more
My mom has onfh (osteonecrosis of the femeral head) on both hip joints and she is 67 years old, is there some effective treatment to heal/resolve it?
Total hip replacemen: Once the bones have necrosed there are really only two option: 1- treat the pain for rest of your life. 2- total hip replacement should be considered. ...Read more
Avascular necrosis: There is no medication to cure avascular necrosis, but the problem can be effectively treated with joint transplantation. It is important to avoid this surgery for as long as comfortably possible, because joint replacements have a limited lifespan and it is not fun to go through multiple procedures. ...Read more
My friend has early stage of avascular necrosis (AVN) of the femoral head. What medication can help him recover?
AVN: AVN is an issue with blood supply to the head of the femur. There are no medications that are routinely used to treat the condition. Stopping the use of alcohol is encouraged, and ceasing steroids may be warranted in consult with the doctor. The main treatment is phyisical therapy for symptom relief, and then surgical measures if the condition worsens during observation. ...Read more
2weeks ago, I (f/31)was diagnosed as bilateral avascular necrosis on femoral head (grade i). How can I do excercise to strength the muscle around hip?
Not related: Not related. Cause of the avn needs to be identified, as well as orthopedic evaluation. ...Read more
I am 60 years old and osteonecrosis of the knee the lateral femoral condyle been battling with pain is there any cure? With electrical stimulation
Yes according to: Mayo clinic, electrical stimulation. Electrical currents may encourage your body to grow new bone to replace the area damaged by avascular necrosis. Electrical stimulation can be used during surgery and applied directly to the damaged area. Or it can be administered through electrodes attached to your skin. ...Read more
A drug side-effect: The drugs for osteoporosis and metastatic bone cancer called bisphosphonates (includes fosamax, actonel, boniva, reclast, (zoledronic acid) zometa, aredia) are associated with a side-effect where part of the bone of the jaw dies, the gum sloughs off, and bone shows where the gum was lost. It is treatable but not always curable. It has also been found with bevicizumab, an anti-cancer drug, and after jaw radiation. ...Read more
Osteonecrosis: This most often is painful but there are times where there is not much pain. You cannot use this as diagnostic symptom. You need to have your dentist evaluate things to make sure what is going on. ...Read more
Pain swellilng: Pain swelling of the jaw, sometimes exposed bone. Usually after tooth extraction. Not always. See oral surgeon to sort things out. ...Read more
Dead bone: Osteonecrosis is dead bone. If the disease keeps progressing, the jaw may have to be resected for cure. Difficult problem. Make sure you are managed by an oral & maxillofacial surgeon. ...Read more
Risk is low.: Risk of osteonecrosis is low but not zero. If you plan on having an extraction, make sure you see an oral surgeon. He knows what to do to minimize the risk. ...Read more
From: http://www. Merck. Com
ONJ, which can occur spontaneously, is generally associated with tooth extraction and/or local infection with delayed healing, and has been reported in patients taking bisphosphonates, including FOSAMAX (alendronate). Clinical judgment of the treating physician and/or oral surgeon should guide the management plan of each patient based on individual benefit/risk assessment. ...Read more
Rare, but: It is rare with oral bisphosphonates like Fosamax (alendronate). More common with IV bisphosphonates. However, medicine related osteonecrosis of the jaws (MRONJ) is suck a devastating disease, that precautions are in order for any dental extraction procedure. Oral surgery evaluation recommended for any patient on Fosamaz. ...Read more
Low risk: There is a definite but low risk of developing osteonecrosis (dead bone) in patients who have taken fosamax (alendronate). The risk is higher for other bone building medications taken intravenously. Patients taking Fosamax (alendronate) should discuss any dental procedures with the dentist to see if special precautions must be taken. Sometimes, a 3 month holiday from Fosamax (alendronate) is helpful to minimise the risk of osteonecrosis. ...Read more
Can aromatose inhibitors cause osteonecrosis of the jaw? I know bisphosphanates can, but what about other meds?
They do not!: Since they lower Estradiol levels, they can make osteoporosis more likely, but the do not cause osteonecrosis of the jaw! Obviously used for estrogen receptor positive breast ca, Evista (raloxifene) would be a good trade for your tamoxifen, in the sense that it would prevent osteoporosis as well as breast ca! ...Read more
I took zometa IV 7yrs ago. Now I have osteoporosis & was prescribed an oral similar drugs. Will this cause osteonecrosis of jaw? My tooth hurts!
See dentist: You can have dental treatment while you are taking medications for osteoporosis. Dental care is extremely important and you want to save your teeth if possible. Your dentist will discuss the very low risk of osteonecrosis after extractions with you. Try to treat the tooth rather than remove it. ...Read more
I suffer from osteonecrosis of the jaw (severe) and need a CT of the brain. Will the CT make my jaw worse?
I have osteonecrosis of the jaw (severe) I need a CT of the brain. Will having a CT make my condition worse?
No: The ct will provide valuable information as to where the dead (often infected) bone is located. While ct scans do impart some radiation, a single scan is not enough to cause a problem. ...Read more
I need bisophanates but am so frightened of the side effects of osteonecrosis of the jaw, thrombosis, stroke, bone cancer etc etc how common are these?
Not so common: And much less common than the dread complications of osteoporosis. I'm not impressed with what I've read about the stroke or cancer risk; good oral hygiene and early recognition should help with the uncommon jaw osteonecrosis. Would like to hear from others about what they've decided. ...Read more
The bone will be: Soft not hard bescuse the bone lost it is mineral.Avascular necrosis occurs when blood flow to a bone is interrupted. Loss of blood flow can result from joint injury, narrowed or clogged blood vessels (from fat or sickle cell anemia), or from excessive pressure inside the joint. ...Read more
Want to stay fit, enjoy running. I was diagnosed with avn or avascular necrosis in left femur head. Will running make it worse?
Yes: I'm sorry to hear of your recent dx. Of AVN of your hip. Hopefully it is inan early stage and can be treated without replacement as an option yet...in my experience Avn will advance in severity w/ time and loading the femoral head repeatedly (as in running) may hasten the process. Best of Luck to you! ...Read more
Limit weight bearing: As a general pediatrician, I have had several patients respond well to crutches and limited activity, although in some situations, short term casting may be recommended. A good reference is: http://www. Mayoclinic. Org/diseases-conditions/legg-calve-perthes-disease/basics/definition/con-20035572. Depending on the severity of your child's condition, your doctor may have other recommendations. ...Read more
osteonecrosis or avascular necrosis (avn), is essentially death of bone. It can happen from trauma, medications, as well as many other causes.
The specific bone that is affected & how severe the osteonecrosis is makes a big difference. Bones like the femoral head (at hip) or the talus can cause severe impairment. Avn of the humerus at the shoulder is sometimes well tolerated. ...Read more
Osteonecrosis of the knee is a common source of debilitating knee pain.
It generally affects the medial femoral condyle in women >55yrs old.
Secondary osteonecrosis of the knee is related to corticosteriod use, alcohol abuse, sickle cell anemia, systemic lupus erythematosus. Secondary osteonecrosis is generally in patients <45 years old and is often bilateral. ...Read more
Nonoperative treatment usually results in a poor prognosis.
Core decompression core decompression is currently the most common procedure in the early stages of osteonecrosis of the femoral head. Based on harris hip scores operative treatment was successful in approximately 70% of hips with ficat stage I ii or iii osteonecrosis comparing to 20% of nonoperative management of early osteonecrosis. ...Read more
Nothing I'm aware of: Osteonecrosis is a poorly understood process. It can be caused by steroids, trauma, vascular insult, alcohol, or be idiopathic. Once it has started, I am not aware of any medications or alternative medicines which arrest the process. There has been some suggestion that bisphosphonates can arrest the process in the case of idiopathic osteonecrosis (perthes), but this is still investigational. ...Read more
Yes: I have not personally, but this is a problem that has been written about extensively. There is a direct causal relationship between the two. ...Read more