Bone and Joint Action Week is held annually October 12-20 with activities focused on disorders including arthritis, back pain, Osteonecrosis,Osteoarthritis trauma, pediatric conditions, and osteoporosis. The themes and their related activities are designed to raise awareness worldwide about prevention, disease management and treatment.
Statistics on Avascular Necrosis (AVN, Osteonecrosis, Aseptic Necrosis, Ischaemic Necrosis, Femoral Head Necrosis)
Frequency depends on the site involved. The most common site is the hip; other locations include the carpals, talus, and humerus. In most countries, exact figures on incidence and prevalence are unknown.
One Japanese survey estimated that 2500-3300 cases of AVN of the hip occur each year; of which, 34.7% were a result of corticosteroid abuse, 21.8% to alcohol abuse, and 37.1% to idiopathic mechanisms. A French study reported AVN in 4.3% of allogenic bone marrow transplant recipients.
Race: No racial predilection exists except for AVN associated with sickle cell disease and hemoglobin S and SC disease, which predominantly are diagnosed in people of African and Mediteranean descent.
Sex: The male-to-female ratio depends on the underlying cause, although primary AVN is more prevalent in men. The overall male-to-female ratio is 8:1.
Age: Age at onset depends on the underlying cause. Primary AVN most often occurs during the fourth or fifth decade and is bilateral in 40-80% of cases. On average, women present almost 10 years later than men.
Risk Factors for Avascular Necrosis (AVN, Osteonecrosis, Aseptic Necrosis, Ischaemic Necrosis, Femoral Head Necrosis)
Avascular necrosis has several causes. Loss of blood supply to the bone can be caused by an injury (trauma-related avascular necrosis or joint dislocation) or by certain risk factors (nontraumatic avascular necrosis), such as some medications (usually steroid basesd), steroid abuse in general, blood coagulation disorders like sickle cell, Factor V, FactorViii, MTHFR, eNOS and more, chemo and radiation infections in the Bone vascular issues such as vascularitis or alcohol abuse. Increased pressure within the bone also is associated with avascular necrosis. The pressure within the bone causes the blood vessels to narrow, making it hard for the vessels to deliver enough blood to the bone cells.Many deep sea divers get Avascular Necrosis from a condition known as the bends. Gaucher disease.
Progression of Avascular Necrosis (AVN, Osteonecrosis, Aseptic Necrosis, Ischaemic Necrosis, Femoral Head Necrosis)
Hip Stages of avn-on
The natural history of osteonecrosis is directly linked to the size and level of the necrosis. Very small lesions (involvement of less than 15% of the femoral head) may resolve without any further treatment. Conversly, lesions involving greater than 50% of the femoral head progress to collapse, and ultimately require in total hip arthroplasty.
Symptoms of Avascular Necrosis (AVN, Osteonecrosis, Aseptic Necrosis, Ischaemic Necrosis, Femoral Head Necrosis)
In the early stages of avascular necrosis, patients may be asymptomatic. However, as the disease progresses most patients will begin to experience joint pain; at first, only when putting weight on the affected joint, and eventually even when resting. Pain usually develops gradually and may be mild or severe.
If the level of necrosis progresses further and the bone and surrounding joint surface collapse, pain may develop or dramatically increase.
The pain may be severe enough to limit the patient’s range of motion in the affected joint.
In some cases, particularly those involving the hip, disabling osteoarthritis may develop.
The period of time between the first symptoms and loss of joint function is different for each patient, ranging from several months to more than a year.
How is Avascular Necrosis (AVN, Osteonecrosis, Aseptic Necrosis, Ischaemic Necrosis, Femoral Head Necrosis) Diagnosed?
In the earliest stages of Avascular necrosis plain x-rays are often normal. A magnetic resonance image (MRI) is the key that allows us to detect AVN at its earliest stage.
Osteonecrosis develops when the blood supply to a segment of bone is disrupted. Without adequate nourishment, the affected portion of bone dies and gradually collapses. As a result, the articular cartilage covering the bone also collapses, leading to disabling arthritis.
Osteonecrosis of the knee can affect anyone, but is more common in people over the age of 60. Woman are three times more likely than men to develop the condition.
It is not always known what causes the lack of blood supply, but doctors have identified a number of risk factors that make someone more likely to develop osteonecrosis.
Injury. A knee injury—such as a stress fracture or dislocation, meniscus tear, bruised patella or combined with some type of trauma to the knee, can damage blood vessels and reduce blood flow to the affected bone.
Oral corticosteroid medications.
Many diseases, such as asthma and rheumatoid arthritis, are treated with oral steroid medications.
Although it is not known exactly why these medications can lead to osteonecrosis, research shows that there is a connection between the disease and long-term steroid use. Steroid-induced osteonecrosis frequently affects multiple joints in the body.
Osteonecrosis of the knee is associated with medical conditions, such as obesity, sickle cell anemia, and lupus.
Transplants. Organ transplantation, especially kidney transplant, is associated with osteonecrosis.
Excessive alcohol use.
Overconsumption of alcohol over time can cause fatty deposits to form in the blood vessels as well as elevated cortisone levels, resulting in a decreased blood supply to the bone.
Chemo therapy and radiation Non-traumatic osteonecrosis of bone is recognized as a potential complication in solid-tumour cancer patients receiving treatment with cytotoxic chemotherapy.
Regardless of the cause, if osteonecrosis is not identified and treated early, it can develop into severe osteoarthritis. And for some with osteoarthritis before avn the disease is even more painful.
Knee stages of avn-on
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