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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Hip Damage Due To Accident. Should I Go For Surgery Or Medication?

Hi,

I received accident for hip(L),AVN, and operated with 5 screws 2 years back and now getting pain now. Doctors saying hip is damage due to decreasing blood supply.

i consulted 4 doctors here, 2 doctors saying hip replacement option and one doctor saying replace screws and then re-drilling(core decompression) will improve blood circulation because one screw is touching up with rib and spoiling the rib . And one doctor saying no need to removal of screws, use medicine 6 months and do some exercises,cycling and swimming.

please find the attached the X Ray .

I am expecting help to suggest one good approach.

Thanks & Regards
Ram
Fri, 2 Aug 2013
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Orthopaedic Surgeon, Joint Replacement,  's  Response
Hi, thanks for writing to HCM.

The treatment of AVN of hip depends on the STAGE OF THE DISEASE, AGE OF THE PATIENT and THE SIZE OF THE LESION.

Total hip repalcement (THR) is the treatment of choice for an ELDERLY person with stage 3 or 4 disease.

In YOUNG individuals with stage 2 or 3 - Core decompression with or without fibular grafting or osteotomies of the femur are considered. In stage 4 cases, THR is the only option.

To simplify, when the disease process is confined only to the femoral head without any involvement of the acetabulum, either core decompression or osteotomies are helpful. If the acetabulum is also involved, then THR is indicated.

An MRI scan is mandatory to exactly assess the extent of disease process.

Hope this information is helpful. Good day

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Hip Damage Due To Accident. Should I Go For Surgery Or Medication?

Hi, thanks for writing to HCM. The treatment of AVN of hip depends on the STAGE OF THE DISEASE, AGE OF THE PATIENT and THE SIZE OF THE LESION. Total hip repalcement (THR) is the treatment of choice for an ELDERLY person with stage 3 or 4 disease. In YOUNG individuals with stage 2 or 3 - Core decompression with or without fibular grafting or osteotomies of the femur are considered. In stage 4 cases, THR is the only option. To simplify, when the disease process is confined only to the femoral head without any involvement of the acetabulum, either core decompression or osteotomies are helpful. If the acetabulum is also involved, then THR is indicated. An MRI scan is mandatory to exactly assess the extent of disease process. Hope this information is helpful. Good day