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    Avn Hip

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    Chitra Chauhan
    This document discusses avascular necrosis of the hip, including risk factors, stages of progression, diagnosis methods like MRI and X-ray signs, symptoms like groin pain, and management options depending on the stage like core decompression surgery or hip replacement if collapse has occurred.

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    Avn Hip

    Uploaded by

    Chitra Chauhan
    15 views11 pages
    This document discusses avascular necrosis of the hip, including risk factors, stages of progression, diagnosis methods like MRI and X-ray signs, symptoms like groin pain, and management options depending on the stage like core decompression surgery or hip replacement if collapse has occurred.

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    stages of avn

    Original Title

    AVN HIP PPT

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    This document discusses avascular necrosis of the hip, including risk factors, stages of progression, diagnosis methods like MRI and X-ray signs, symptoms like groin pain, and management options depending on the stage like core decompression surgery or hip replacement if collapse has occurred.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    15 views11 pages

    Avn Hip

    Uploaded by

    Chitra Chauhan
    This document discusses avascular necrosis of the hip, including risk factors, stages of progression, diagnosis methods like MRI and X-ray signs, symptoms like groin pain, and management options depending on the stage like core decompression surgery or hip replacement if collapse has occurred.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
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    AVASCULAR NECROSIS OF HIP (AVN)

    HIP (AVN)
    AVN of the femoral head is a pathologic process that results from
    interruption of blood supply to the bone.

    Femoral head ischaemia causes bone marrow and osteocytic


    death, leading to collapse of the necrotic segment of the head of
    femur..
    ETIOPATHOGENESIS OF HIP AVN
    Etiopathogenesis is not well understood Risk Factors include:
    •Genetic predilection[1]
    •Corticosteroid intake[2]
    •Alcohol
    •Smoking
    •Various chronic diseases [3] eg sickle cell disease, human immunodeficiency virus ,
    hypercoagulable states, autoimmune disorders[4][5].
    STAGES OF HIP AVN
    AVN progresses through four stages:
    1.Initial/necrosis: blood supply gets disrupted, and necrosis begins
    2.Fragmentation: the body resorbs the necrotic bone and replaces it with woven bone that is weak
    and vulnerable to breaking and collapse
    3.Reossification: stronger bone develops
    4.Healed/Remodeling: bone regrowth is complete, and final shape present (depending on damage
    may be normal or abnormal).[6]
    FICAT-ARLET CLASSIFICATION
    DIAGNOSIS OF HIP AVN
    •Earlier diagnosis of AVN in the disease process leads to success of the
    treatment, as it relates to the stage at which the treatment starts.
    •Diagnosis be made with plain radiographs in moderate/late disease
    •MRI may be required to detect early or subclinical osteonecrosis.

    •Crescent Sign: On Xray, a thin, curvilinear lucent line parallel to the


    cortical margin of the femoral head, in a patient with AN.
    SYMPTOMS OF HIP AVN
     Patients complaints of groin pain , but symptoms can also radiate to the knee or
    buttocks.

     On examination - painful range of motion, especially on forced internal rotation

     Investigators need to be wary of avascular necrosis in any patient who has pain in
    the hip, negative radiographic findings, and any of the risk factors, described above.
    The other hip must also be evaluated.
    MANAGEMENT

    The precise therapy used depends on many factors, with each patient being evaluated individually for best
    outcomes.
     Factors such as
    • age of the patient,
    • level of pain/discomfort,
    • location and extent of necrosis and
    • comorbidities.

    Treatments are best implemented at the pre-collapse stage and include both operatives as well as non-
    operatives options. If left untreated, femoral head AN may lead to subchondral fractures within only 2 to 3
    years.
    MANAGEMENT

    •If femoral collapse has occurred or acetabular involvement is present, arthroplasty is indicated.
    •Core decompression - is a surgical procedure that requires surgical drilling into the area of dead
    bone near the joint, reducing pressure, allows for increased blood flow.
    This aims to slows or stops bone and/or joint destruction.

    •Post surgical rehabilitation is a key component for recover, which It starts immediately after
    surgery.
    CONSERVATIVE MANAGEMENT

    Conservative management includes :--


     Targeted pharmacologic therapy - pain control medication
     Alcohol cessation
     Discontinuation of steroid therapy
     Physiotherapy –
     restricted weight-bearing by using walking aids
     Range Of Motion exercises
     Strengthening exercises with in the limit of pain
     Balance and gait training
    THANK YOU

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