Osteonecrosis, also called avascular necrosis or aseptic necrosis, is the death of a region of the bone when its blood supply is interrupted, with a bone infarction, which causes pain, bone collapse and can cause severe arthrosis.
Although it can appear in any bone in the body, osteonecrosis occurs more frequently in the hip, affecting the region of the femoral head, as well as in the knees, shoulders, ankles, wrists or in the jaw bone.
The treatment is done by the orthopedist, and consists of the use of medications to relieve symptoms, with anti-inflammatories, in addition to rest and physiotherapy, however, surgery to correct the changes or even to replace the joint may also be indicated. a prosthesis.
Main symptoms
Initially, osteonecrosis may have no symptoms and can hardly be seen on imaging studies. But as the blood circulation worsens and there is more bone involvement, symptoms such as pain in the affected joint may appear, which causes difficulties in walking or doing daily activities.
One or more bones can be involved in this disease and, in osteonecrosis of the hip, only one or both sides can be affected. Also, learn to identify other causes of hip pain.
After the suspicion of osteonecrosis of the hip, the orthopedist may perform a physical evaluation and request exams such as radiography or MRI of the affected region, which may show signs of bone necrosis, as well as bone adaptations that may arise, such as arthrosis.
What are the causes
The main causes of osteonecrosis are bone injuries that occur due to trauma, as in cases of fractures or dislocations. However, non-traumatic causes include:
- Use of corticosteroid drugs, when in high dose and for long periods of time. Check out the main side effects of corticosteroids; Alcoholism; Diseases that cause changes in blood clotting, such as sickle cell anemia, liver failure, cancer or rheumatological diseases; Use of Bisphosphonate class medications, such as zoledronic acid, used to treat osteoporosis and some cases of cancer, is related to an increased risk of osteonecrosis of the jaw.
People who smoke may also be more likely to develop osteonecrosis, because smoking causes difficulties in the blood supply in the body.
In addition, there are cases in which it is not possible to discover the cause of the disease, and these cases are called idiopathic osteonecrosis.
How the treatment is done
Treatment for osteonecrosis is guided by the orthopedist (or maxillofacial surgeon in the case of osteonecrosis of the jaw), and includes the use of analgesic and anti-inflammatory drugs to relieve symptoms, rest of the affected joint, physical therapy, in addition to the elimination of the cause that can causing the blood to be insufficient.
However, the main treatment that generates the best results for curing osteonecrosis is surgery, which involves performing bone decompression, placing a bone graft or, in the most severe cases, replacing the joint.
Physiotherapy for Osteonecrosis
Physiotherapy is very important to help the patient's recovery, and can vary depending on the type and severity. When the bone is very affected by the difficulty of blood supply, it is common to have a decrease in space within the joint and inflammation, which is why it is common to develop arthrosis and arthritis.
In physiotherapy, muscle strengthening exercises, joint mobilization and stretching can be performed in order to reduce the risk of complications in the affected area, such as a fracture, and even to avoid placing a prosthesis. The devices can also help control pain and strengthen muscles.
See how the treatment can be done after placing the hip prosthesis.
