Avascular necrosis is the death of bone tissue due to a lack of blood supply. It is also called osteonecrosis, which can lead to the occurrence of small fragments of bone and bone tissue will die and be brittle. Broken bones or shifting joints can block blood flow to certain parts of the bone.
Avascular necrosis is also associated with long-term and high doses of steroid drug use, as well as consuming a lot of alco**hol. Everyone can suffer from this, but this condition often occurs in people between the ages of 30-50 years old.
Death of Bone Tissue / Avascular necrosis symptoms
In the early stages, avascular necrosis usually does not cause symptoms. However, when the disease develops or worsens the sufferer may feel pain when there is pressure on the affected part of the bone.
As the disease progresses, the pain will become more constant. If the disease develops, the surrounding bones and joints can become brittle and damaged, so the sufferer will experience severe pain and interfere with the ability to use the joints.
The intensity of pain can increase because there are small fragments of bone (microfractures), which can cause bones to become brittle. In the end, the joints can experience damage and cause arthritis. The time between the appearance of the first symptoms and the brittleness of the bones can vary, from a few months to more than a year. And symptoms can occur on both sides of the body.
Avascular necrosis can occur in any bone in the body, but most often on:
- Upper arm bone.
- Pelvic bones.
- Knee joint.
- Shoulder joint.
- Ankle joint.
Avascular necrosis causes
Avascular necrosis occurs due to reduced blood supply to the bone. Some conditions that can make the blood supply to the bones reduced are:
Injuries to joints or bones
Injuries such as dislocation can damage the blood vessels around the troubled joint, thus inhibiting the blood supply to the bone.
Build-up of fat in blood vessels
Fat can block small blood vessels and result in reduced blood supply to the bones. This can happen in people who use corticosteroids for a long time or people who are addicted to alco**hol.
Medical measures, such as radiotherapy, can weaken bones and damage blood vessels. In addition to radiotherapy, the act of kidney transplantation is also thought to cause avascular necrosis.
Basically, avascular necrosis can be experienced by anyone. However, there are several factors that make a person more at risk of suffering from this condition, namely:
- Consume alco**hol excessively
- Have a habit of smo**king
- Taking steroid drugs, such as cortisone and prednisone, for a long time
- Suffer from certain diseases, such as Legg-Calve-Perthes disease
- 30–60 years old
In some cases, the cause of avascular necrosis is not known for certain. The disease can occur in healthy individuals without having any of the above conditions or risk factors.
Death of Bone Tissue / Avascular necrosis diagnosis
Your doctor will suspect Death of Bone Tissue / Avascular necrosis (AVN) if the patient has bone pain that occurs only in small areas. To examine the bones, supporting examinations will be carried out such as: X-rays, MRI, CT scans, bone scans, and functional bone tests.
Bone scans will be performed when X-ray examinations show normal results. Functional bone tests will be performed when the doctor suspects an AVN but all other examinations such as X-rays, MRI, and bone scans show normal results.
Avascular necrosis treatment
Treatment of Avascular necrosis (AVN) depends on the patient’s characteristics such as age, causative factors, area of the affected joint bone, and severity. Treatment may also change with the change or severity of the disease.
The purpose of treatment is to overcome the cause, reduce pain, help restore joint function, prevent more severe damage to the joints, and maintain bones and joints.
The treatment that can be given in the form of medication to injectable therapy to reduce pain. Limiting activity and pressure to the affected joints is also necessary to prevent more severe damage to the bones and prevent microfracture. Range of motion exercises are also recommended to help maintain joint function.
While cholesterol drugs can be given to help improve blood circulation. The bisphosphonate drug can help prevent bones from collapsing. When all treatment is done, but no improvement of the condition occurs, surgery may be required. Some surgical procedure options include core decompression, bone grafting, vascularized fibula graft, osteotomy and total replacement.