AVN of the Hip Non-surgical Treatment to avoid Hip Replacement Surgery

AVN of the Hip Non-surgical Treatment to avoid Hip Replacement Surgery

AVN and its Non-surgical Treatment:

AVN (Avascular Necrosis) of the Hip Joint is a painful condition, caused by disruption of blood supply to the Head of the Femur due to some traumatic or non-traumatic condition and causes the death of bone tissue. Avascular necrosis ultimately leads to the destruction of the hip joint and severe Arthritis. Avascular Necrosis is also called Osteonecrosis. Anyone can be affected but this condition is most common in people between the age of 30 to 50

Causes of Avascular Necrosis are-

  • Fracture,
  • Dislocation,
  • Chronic Steroid use,
  • Chronic Alcohol consumption,
  • Smoking,
  • Blood Disorders (coagulopathy & sickle cell anemia),
  • Diabetes,

Avascular Necrosis develops in stages. It may take from months to over a year for the disease to progress. 1st stage is generally asymptomatic and only seen in MRI. In the 2nd stage, mild destruction can be visible in X-Ray and the hip joint is painful. In the 3rd stage, the pain worsens, the patient is unable to put the affected leg on the ground, and the joint space becomes narrower. 4th stage is characterized by the collapse of subchondral bone and arthritic changes started. In the 5th stage, both the articular surfaces are affected.

Early physiotherapy treatment can slow down the progression of the disease and decrease associated pain and improve functionality. Patients with stages 1 and 2 could benefit from physiotherapy treatment.

Initial-stage treatment protocols are

  • Teaching the use of crutches
  • Passive hip ROM exercise
  • Active hip exercise
  • Mild stretching of muscle surrounding the affected hip joint

Post 2 weeks progression is

  • Strengthening exercises
  • Core strengthening exercise

After 6 weeks includes

  • Endurance
  • Balance & Coordination training
  • Bridging for trunk stability
  • Pelvic press exercise
  • Treadmill walking
  • Static cycling
  • Stair step-up forward/side

Other physiotherapy tools to relieve your pain and improve the condition

  1. Ultrasound Therapy
  2. Extracorporeal shock wave therapy
  3. Super Inductive System Therapy
  4. Electro Magneto Therapy (this therapy may reverse the disease to some extent and stops the progression of the disease but this treatment is a very slow process it may take up to 1 year)

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