Avascular Necrosis
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Cynthia777
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mald
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@mald I did a bit of research and Mr Jeremy Parker's hip numbers look very good. You want someone who focuses on hips (he does) and does 200+ THRs in a year. His number in the National Joint Registry is 263 from March 2013 - April 2014. Of course the most important issue in all this is that you trust your surgeon and feel comfortable working with him. If that's the case - you are good to go!
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mald
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@Jaycey many thanks for the research. Mr Parker is obviously a very busy man and experienced with THR. I have confidence in him. I will have the MRI on my 'good' hip and see if AVN is a hidden time bomb in that one too. I will also give the hip injection a punt. My mind is set on having the replacement within the next 6 months whilst I am fit and healthy.
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About this link.....please note the excerpt from it that I've copied here and highlighted in bold type:
Some medications are known to cause AVN. Cortisone is the most common drug known to lead to AVN. This is usually only a problem in patients who must take cortisone every day due to other diseases, such as advanced arthritis, or to prevent rejection of an organ transplant. Sometimes there is no choice, and cortisone has to be prescribed to treat a condition, knowing full well that AVN could occur. AVN has not been proven to be caused by short courses of treatment with cortisone, such as one or two injections into joints to treat arthritis or bursitis.
As Jo mentioned in a post above, the type of cortisone used in joint injections is not a cause of AVN. This article is not particularly clear about all of this. But the paragraph I quoted does try to make the distinction between the two types of treatment with "cortisone" drugs. One just has to read it carefully to get the distinction.
The bottom line is that, while injections may or may not provide some temporary relief, you should not worry about the risk of developing or worsening avascular necrosis by getting one.
Well, take heart. Once you have that hip replaced, all the necrotic bone will be gone and your shiny new hip will allow you to do the things you want with no pain. So when you get to the point where you are ready for a THR, it will be a big step forward for you (literally!).
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mald
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@DeepBreath good luck with your operation tomorrow, hope all goes well for you and you're back on your feet in no time.
awolfpaw
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Hi @mald I too have AVN in my hips (and knees, and shoulders...) Have you checked for AVN in other joints? If you can catch it early, you can do more minor maintenance (such as core decompressions) and possibly save the joints
Of 46 is too young, then im SOL lol. Im 28 and will be having my left hip replaced this November. I did the shot thing to try and buy time, but it didnt work. Im not saying dont try it, Im just giving you my experience (as I am stage 4/5 AVN in that hip). My advice is to keep looking for AVN doctors specifically. You will find that many doctors are not well versed in the disease and brush you aside. A doctor with AVN experience will understand better and may have different options
Dont let ANYONE tell you that youre too young for a replacement. You are living in pain! You dont do the things you love! You sound a lot like me: I went from going to the gym 3 times a week...to be unable to sit in the car for too long without pain. I have to plan out my vacuuming schedule to make sure I dont have any big events coming out, because vacuuming leaves me in pain. At any age, that is NOT the way to live.
If you are on facebook, there are a few Facebook groups you should join...very helpful people all dealing with AVN.
GOOD LUCK!
Of 46 is too young, then im SOL lol. Im 28 and will be having my left hip replaced this November. I did the shot thing to try and buy time, but it didnt work. Im not saying dont try it, Im just giving you my experience (as I am stage 4/5 AVN in that hip). My advice is to keep looking for AVN doctors specifically. You will find that many doctors are not well versed in the disease and brush you aside. A doctor with AVN experience will understand better and may have different options
Dont let ANYONE tell you that youre too young for a replacement. You are living in pain! You dont do the things you love! You sound a lot like me: I went from going to the gym 3 times a week...to be unable to sit in the car for too long without pain. I have to plan out my vacuuming schedule to make sure I dont have any big events coming out, because vacuuming leaves me in pain. At any age, that is NOT the way to live.
If you are on facebook, there are a few Facebook groups you should join...very helpful people all dealing with AVN.
GOOD LUCK!
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mald
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@awolfpaw thank you for your input. Sorry to hear that you are suffering too! Good luck with your hip replacement.
Out of interest, was the hip injection straight forward? I know I need to have it undertaken in the operating room but that's all I know at this moment. Any further info would be appreciated.
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Out of interest, was the hip injection straight forward? I know I need to have it undertaken in the operating room but that's all I know at this moment. Any further info would be appreciated.
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awolfpaw
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Its very straight forward and easy. They are injecting the cortisteroids directly into the joint in hopes to give you more time/alleviate the pain before a hip replacement. And when it comes to hip replacements, the longer you wait th ebtter because they only last so long (though every person is different). But you obviously dont want to miss out on life either. Since its not just subcutaneous (right under the skin), they have to stick the needle very far in to get to the joint (guided by xray I believe).
This is not necessarily the case. Old school thinking and older technology meant hips needed to be revised after 10-15 years. But these days surgeons are talking more and more about the forever hip. Depends on your level of activity and lifestyle as well.
As as for waiting when you have AVN - the longer the wait the longer the recovery. The joint continues to become more and more diseased. It is a very different recovery if you wait until the joint has collapsed.
awolfpaw
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I do agree with this as well. I know I hate hearing it from doctors, but they are right when they say "everyone is different". Ive talked to a LOT of people with hip replacements, and Ive seen anything from revision in 10 yrs, to people who are going on 30 yrs with no issues with their first hip! Dont let the time frame scare you away, Ive learned there really is no telling how long it will last
As for the second part, Ive never had anyone tell me this before? I am stage 4 almost stage 5 AVN in my left hip. My doctor described my hip as "a square peg trying to fit into a round hole". The femoral head is flat. But no one said "recovery will be harder due to collapse". Maybe it wasnt addressed because I didnt not have the replacement option when it was say, stage 3? I went to the doctor and just started out with a crappy hip bone. lol
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awolfpaw
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I was asleep as I was also having surgery to remove a surgical pin that was causing bursitis. So unfortunately I cant say which i'd prefer :/
I HAVE done many spinal taps/bone biopsies in my lifetime, and they gave me a mild anesthetic. It made me dopey and sedated, and lessed the pain ( or at least the focus on it). I found it very helpful as it was enough and didnt need to go completely under. This might be an option worth talking about with your doctor?
I HAVE done many spinal taps/bone biopsies in my lifetime, and they gave me a mild anesthetic. It made me dopey and sedated, and lessed the pain ( or at least the focus on it). I found it very helpful as it was enough and didnt need to go completely under. This might be an option worth talking about with your doctor?
Usually with the sedation, you are given just enough medication to know what is going on but it won't hurt and you really don't care. You're in a twilight la-la land. It can work quite well. If you find you're anxious about the procedure when you arrive at the hospital, sometimes you can also be given a little something to relax you until you go into the surgery theater. Communication with your medical team is essential to be sure you are very comfortable for the whole thing.
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