Suggest Treatment For Avascular Necrosis Of Hip

Posted on Wed, 23 Apr 2014

Medically reviewed by Ask A Doctor - 24x7 Medical Review Team

Wed, 23 Apr 2014 Answered on

Tue, 13 May 2014 Last reviewed on

Question : I had undergone Core-decompression surgery of both hip-joints due to AVN in Dec 2011. Cause told to me for AVN :- - Steroidal history of 11 years till date included in medications which have been prescribed by doctors for slip disc, that continued for over 6 months and it deteriorated my physical conditions and a few movements which came to my notice after approx. an year. - Medical History :- Asthma (first diagnosed in 2004 but was fine with city and climate change in 2010), PCOD (still there since 2007), Thyroid from 2002 (taking regular medicines). - Conditions Now:- Pain in leg everyday. Movements restricted for bending sideways, downwards and also sitting cross-legged. I have been suggested for Bone transplant, but would like to know if there is an option to avoid this major surgery (or delay it) or if I can achieve a normal state by physiotherapy, medicines, special diet, etc. Please let me know in case you need any further details.

Answered by Dr. Dr. Naveen Kumar Sharma (29 minutes later)

Brief Answer: Difficult to avoid Hip replacement Detailed Answer: Hello XXXXXXX I have studied your case. As you know that AVN happens because you took steroids. Your medical history is suggesting that you are still on steroids. So core decompression or any other procedure to delay surgery will not be going to work. I can recommend you to take alendronates 10 mg daily. This drug has shown good results in delaying AVN. I would also suggest you to discuss with your doctor if steroids can be avoided in you. As far as activity is concerned, I would suggest you to loose some weight, avoid sitting on floor or any excessive activity. As far as diet is concerned , avoid fat, sweets so you would not gain much weight. Total hip replacement is last option and I would suggest you to avoid it till it possible. If you can send me the X ray then I can say whether hip replacement can be delayed or not. Let me know if you want to ask any thing else. Best of luck for your health. thanks and take care.

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj

Follow up: Dr. Dr. Naveen Kumar Sharma (17 minutes later)

The steroids currently are limited to whenever allergy occurs (not regularly) and taking it after discussing the details with doctor (as suggested these cannot be avoided). I will start with alendronates 10 mg daily as you suggested (I assume it’s the name of medicine which I can get directly from chemist). I will also send the X-ray image in a couple of hours. Here are few more queries I have: 1. I have started with reducing weight but for physical activity I wanted to know more on which exercises I can start with (considering it would not worsen the joint pain). Please suggest. 2. Apart from reducing fats/ sweets to avoid gaining weight could you please let me know if there are any suggestions what additionally I can include in diet which will avoid joint to lose agility?

Answered by Dr. Dr. Naveen Kumar Sharma (13 minutes later)

Brief Answer: Avoid jumping, running Detailed Answer: hello, I would suggest you to walk in park with normal speed. Do not run, jump or use treadmill. In park also avoid track(hard surface) and walk on grass. 2. There are no specific food items for joint and I would suggest you to take balance diet. Take B complex tablets also as you are already taking too many medicines which can cause low vitamin level in body. 3. take care of thyroid also as low thyroid can cause weight gain. 4. Alendronate available by the name of osteofos, zolfos . send me X ray so that I can offer you better advice. Thanks and take care.

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj