Osteonecrosis
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What is osteonecrosis?
Osteonecrosis or aseptic necrosis is the involvement of bone cells as a result of the decrease in blood supply, that is, when blood stops circulating properly through the bones, it produces a lack of oxygen that deteriorates bone cells and produces the development of osteonecrosis.
This condition is also known as avascular necrosis and occurs, in most cases, in the long bones of the joints such as the head of the femur, although it can be found anywhere in the bone structure.
Osteonecrosis can cause bone to collapse because the cells that keep it strong die, if not treated in time the bone structure can break completely.
Osteonecrosis, Signs and Symptoms
As it is a progressive disease, noticing the signs can be difficult at first, among the symptoms we can mention.
Occasional joint pain:
It can be when bearing weight during the day, for example when carrying boxes or shopping bags, you may feel slight discomfort in the affected area.
Mild ongoing pain:
The most advanced cases begin to present pain that does not stop even at rest, the joint remains in constant discomfort.
As we mentioned, it is not easy to suspect that the bone structure is being affected by osteonecrosis. That is why we recommend going to an orthopedic doctor in case of:
- Having experienced a recent fall that left a discomfort in a joint.
- You suspect you may have a dislocated or fractured joint.
- You have had pain in one or more joints for more than a month.
Causes of osteonecrosis.
This condition can occur under the following conditions:
- Injury or trauma to the joint: After a blow involving a joint, such as the femoral head, blood vessels may become damaged and blood supply decreases, causing advanced osteonecrosis.
- Blood-related diseases: Anemia, Gaucher, leukemia, AIDS are conditions that increase the risk of osteonecrosis, as these patients can develop it. Although it is not easy to determine the exact reason when this disease develops without trauma, scientists can relate these conditions as risk factors.
- Fat blockages in the veins: When there is an unevenness of lipids in the blood, these accumulate in the walls of the blood vessels and veins, including those that nourish the bones, this can become an obstruction that develops osteonecrosis. Excessive consumption of fatty foods that increase cholesterol can trigger a multitude of cardiovascular diseases, including aseptic necrosis.
Diagnostic process.
In addition to the routine clinical process with an orthopedic doctor, in which he evaluates the ability of movement and pain range of the joint, imaging tests will also be used to diagnose avascular necrosis.
The conditions that cause pain are varied, so it is necessary to verify the diagnosis with precise data that can be obtained from tests such as:
- MRI: It is sensitive to show early changes in the bone.
- Bone scan: This is a test that uses radioactive material to paint the areas of bones injured by this disease.
Treatments for osteonecrosis.
Surgical Options
When osteonecrosis shows symptoms, it is because it is in an advanced stage, which means that the doctor requires invasive measures to treat it, such as:
- Bone transplant with graft: A portion of healthy bone taken from the patient is transferred to place it in the damaged area and thus strengthen the damaged area.
- Joint replacement: When the situation is very advanced, the doctor may recommend the change of the areas affected by a joint implant.
- Core Decompression: It is a surgical treatment in which the core of the bone is removed and its external area is left, with this action the regeneration of bone tissue is stimulated and over time the bone heals itself.
If a preventive health routine is maintained and osteonecrosis is detected at an early stage, preserved treatment can be attempted, although these are very isolated cases.
How to prevent osteonecrosis?
We can recommend patients avoid excessive consumption of substances such as corticosteroids and alcohol. As well as maintaining a safe diving system to avoid decompression sickness that brings bone injuries.
What happens if I don't treat osteonecrosis?
It is important to treat osteonecrosis as soon as possible as it is a progressive and degenerative disease that causes the affected bone to weaken, die and break. In addition to causing the patient to suffer from severe pain, it can also cause them to become immobilized.
If you seek the care of an orthopedic doctor in Panama.
Risk Factors for Osteonecrosis:
Osteonecrosis is a condition that can affect people of all ages, but some factors increase the risk of developing it. These factors include:
- Steroid Use: Long-term use of steroids, whether for medical or recreational reasons, can increase the risk of osteonecrosis.
- Excessive alcohol consumption: Excessive alcohol intake can affect blood circulation in the bones, increasing vulnerability to osteonecrosis.
- Traumatic injuries: Joint injuries or trauma, such as fractures or dislocations, can damage blood vessels and increase the risk of osteonecrosis.
- Underlying medical conditions: Medical conditions such as lupus, rheumatoid arthritis, and coagulopathy can increase the risk of osteonecrosis.
- Medical treatments: Some medical procedures, such as radiation therapy, can affect blood circulation in specific areas of the body and increase the risk of osteonecrosis.
- High intravascular pressure: High blood pressure in the blood vessels within the bones can contribute to osteonecrosis.
Types of Osteonecrosis:
There are several types of osteonecrosis, which depend on the location of the affected bone tissue:
- Osteonecrosis of the Femur Head: This is one of the most common forms and affects the upper part of the thigh bone (femur).
- Osteonecrosis of the Patella: In this case, the condition occurs in the patella, the bone that is part of the knee joint.
- Osteonecrosis of the Jaw: Affects the jaw and can be a complication of some medical treatments, such as bisphosphonate therapy.
- Osteonecrosis of Other Bones: It can occur in other bones in the body, such as the shoulder, elbow, or wrists.