THR Research on AVN


junior member
Mar 19, 2022
United States United States
It's only been 6 weeks after surgery and I have developed a cavity. How should I handle it?
My dentist would not see me for 3 months after surgery and then she prescribed antibiotics before my cleaning.
My surgeon suggested using the antibiotics first couple of years but not everyone follows this protocol.
Hello and Welcome to recovery! I hope all has been going well for you aside from the cavity. Please share the date of your right THR so we're able to create a signature for you.
I will leave our Recovery Guidelines below as most of the information will still apply at this point in the healing process.

As far as the cavity, I would advise you contact your surgeon's office for advice from him or his care team. Opinions on dental care vary from surgeon to surgeon as well as from dentist to dentist. Let us know what you hear and best wishes as you continue your recovery!


As you begin healing, please keep in mind that each recovery is unique. While the BoneSmart philosophy successfully works for many, there will be exceptions. Between the recommendations found here, your surgeon's recovery protocol and any physical therapy you may engage in, the key is to find what works best for you.

1. Don’t worry: Your body will heal all by itself. Relax, let it, don't try and hurry it, don’t worry about any symptoms now, they are almost certainly temporary.

2. Control discomfort:
take your pain meds by prescription schedule (not when pain starts!)​

3. Do what you want to do BUT
a. If it hurts, don't do it and don't allow anyone - especially a physical therapist - to do it to you​
b. If your leg swells more or gets stiffer in the 24 hours after doing it, don't do it again.​

4. PT or exercise can be useful BUT take note of these

5. At week 4 and after you should follow this

The recovery articles
Pain management and the pain chart
Healing: how long does it take?
Chart representation of THR recovery
Dislocation risk and 90 degree rule
Energy drain for THRs
Pain and swelling control: elevation is the key
Post op blues is a reality - be prepared for it
Myth busting: on getting addicted to pain meds
Sleep deprivation is pretty much inevitable - but what causes it?

BIG TIP: Hips actually don't need any exercise to get better. They do a pretty good job of it all on their own if given half a chance. Trouble is, people don't give them a chance and end up with all sorts of aches and pains and sore spots. All they need is the best therapy which is walking and even then not to excess.

We try to keep the forum a positive and safe place for our members to talk about their questions or concerns and to report successes with their joint replacement surgery. While members may create as many threads as they like in a majority of BoneSmart's forums, we ask that each member have only one recovery thread. This policy makes it easier to go back and review history before providing advice.
Call your surgeon's office and ask. Let them know whether the tooth is painful.
As for the dentist, they usually have different guidelines for acute care vs routine care like cleanings so you'll need to call that office too.
Good luck!
Hi @Eyak I think your first action is to contact your OS office and see what they advise>
Is it a painful cavity? That will make a difference in how it's addressed, also.

I think we all would be very interested to hear what your surgeon advises you and hope you give us an update.

Welcome to the forum!
Definitely check in in with your surgeon. Dental infections can be very dangerous, especially when you are recovering from any surgery, or are medically fragile. Did a dentist diagnose your cavity? If you know you have a cavity and they don't feel it's wise to have it treated yet, there are several things they likely will have you do daily to reduce the likelihood of infection from it.

In terms of the protocols around taking antibiotics long term prior to all dental work, including cleanings, I asked 3 medical professionals I saw within a couple of months. My family practice doctor said it was unnecessary when I asked for a refill of the amoxicillin prior to my dentist appointment. He said that no longer was accepted practice, and said he was sure my surgeon would agree. I then asked my surgeon, who is quite prominent in the area and widely respected. He said he preferred his patients continue the practice---that it was a simple thing to do to reduce possible infection and problems. He didn't agree anprescribed the antibiotics. When I saw my dentist, he said he would defer to my other doctors, but when told my surgeon recommended it, he breathed a sigh of relief, and basically repeated what the surgeon had said.

I think people can build a case either way, based on what I have heard, and probably either would be fine. Being rather cautious, I do plan to continue the antibiotics until further research indicates it truly is unnecessary or dangerous. My hip replacement recovery 4 years ago went quite well, but I'm not interested in having to have it replaced again due to an infection.
My OS told me maybe GPs and dentists would be advocates of pre-dental antibiotics if they were the ones having to take care of reaming out infected replacements.
I successfully had a right hip replacement a year ago and doing well but with avn you know the story is not over. My avn was caused by the prednisone I am required to take long term after a kidney transplant and since that is more important the avn takes second place. My kidney doctor tried taking me off of prednisone but it did not work. So prednisone is going to cause me problems. During the period of time I was off it, the pain subsided and my movement was improved. So my question is - is there any researcher presently working on treatment to counter the avn side effects of prednisone. I have found some research that prednisone affects lipids and thus reduces blood flow so that new bone development cannot keep up with bone loss. Since I take a statin would changing dosage affect the blood flow? Since blood flow seems to be the problem is there any research or rememidy being investigated to increase blood flow? I am no doctor but I do notice that heat that increases blood flow and reduces pain and cold does the opposite. Like any research, I assume that money is always the answer. Since the population that experiences avn due to prednisone is a small consumer base. But maybe there is some research on the topic. Please send it my way. Thanks.
Hello Eyak,
Welcome back to BoneSmart! I am sorry I don't have any information to share with you, but possibly some members will stop by to offer comments or share wisdom. I do hope you find answers and wish you only the best!
Please share the exact date of your THR so we're able to add it to your signature.

You will notice that we merged your newest thread with your original recovery thread. Having your recovery information contained in one place will make it easier for you to reflect back on. It is also helpful for those stopping by to be able to review your history before advising or commenting.
Please post any updates, questions or concerns about your recovery here.
is there any researcher presently working on treatment to counter the avn side effects of prednisone
We don't have access to this kind of data. I suggest you speak to your kidney doctor about this. As you say, the group of people facing this side effect due to taking prednisone is pretty small so I doubt there is any on-going analysis. Do ask your consultant and let us know what you are advised.

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