Necrosis of the head of the hip joint

Features of treatment of hip joint necrosis

In the diseased joint, cartilage and bone tissue die off

In the affected joint, the cartilage and bone tissue die

Necrosis - the death of some tissues of the damaged organ. There is an ailment as a result of a violation of the blood supply, insufficient supply of essential nutrients to the joint. With necrosis of the hip joint, the bone head is mostly damaged.

The most dangerous complication of osteonecrosis is gangrene, often leading to blood infection or limb amputation. Therefore, if you have pain in the hip or knee joint, and after getting injuries, you should immediately contact a specialist and conduct a survey. Timely diagnosis will help to find out the nature of pain and avoid the risk of developing serious illnesses.


Causes and Symptoms of the Disease

Aseptic necrosis of the hip joint can develop for the following reasons:

  • dislocation or fracture;
  • frequent minor tissue damage and excessive loads( especially with regular sports activities);
  • arterial thrombosis;
  • transferred inflammatory diseases;
  • taking certain medications( antibiotics and hormones in large doses and for a long time);
  • pressure drops( for miners and divers);
  • alcohol abuse.

In 80% of cases, osteonecrosis is bilateral. In addition to the head of the hip joint, it often progresses in the knees, shoulder, elbows and ankles. Osteonecrosis may occur several months or even years after the injury or pathological conditions that provoked it.

Joint type at different stages of the disease

The course of the disease is divided in stages depending on the degree of destruction of the hip or knee joint tissues. Each stage is characterized by the same symptoms, but the intensity of their manifestation is different.

The main symptoms of the disease:

  • pain;
  • atrophic changes of soft tissues of the thigh or knee( if the patient has necrosis of the knee joint);
  • reduction in the amplitude of joint movements;
  • relocation of the body load to a healthy leg.

At the initial stage, the main sign of asthenic necrosis is pain, which appears spontaneously. It concentrates in the region of the hip joint and gives in the groin, the area of ​​the knee joint, waist and sacrum. Pain can stop walking and sitting. Gradually they become more intense and prolonged, especially at night. The possibility of joint motion does not change. The body weight is distributed evenly to both extremities.

Stage 2 osteonecrosis is characterized by persistent pain, especially after physical exertion. The amplitude of movement of joints decreases slightly. There is a significant death of the femoral muscles( the girth of the affected thigh is less than healthy).The load of body weight is gradually transferred to a healthy leg.

With the 3rd stage of the disease, even a minimal load causes a significant increase in pain. Movement of the joint is limited. Muscles are significantly atrophied. The leg may become somewhat shorter.

Osteonecrosis of the 4th stage is characterized by the appearance of soreness, which is most pronounced. There is a violation of gait. Muscular atrophy is clearly pronounced. The amplitude of the motions is zero.


Diagnosis and treatment of osteonecrosis

Complication of the disease led to a fracture of the neck of the hip

Complication of the disease led to a fracture of the femoral neck

The earlier avascular necrosis is detected, the easier it is to treat the disease. Often, x-rays are prescribed for diagnosis, but in the initial stages aseptic necrosis of the hip with the help of this method is almost impossible to determine. The lesion of the joint on the X-ray will be noticeable only at 2 or 3 stages of the disease. Ultrasound and laboratory tests for the diagnosis of necrosis are also ineffective. To detect the disease at the beginning of its development is possible only with the help of computer tomography and MRI.

Treatment can be traditional and operative. Aseptic necrosis of the knee and the head of the hip joint, revealed at the initial stage of development, lends itself to conservative therapy. The purpose of such treatment is to prevent or slow the development of the disease, to relieve or reduce pain, to improve the mobility of the affected joint.

Massage promotes the flow of blood to the joint and the intake of nutrients Traditional treatment includes:
  • reception of analgesic, anti-inflammatory drugs( corticosteroids, non-steroid drugs);
  • exercise therapy;
  • physiotherapy procedures( electrophoresis with novocaine, ozocerite, ultrasound methods, use of diadynamic currents, etc.);
  • massage, enhancing the functionality of muscle tissue;
  • use of orthopedic prophylactic orthoses.

The main requirement for all treatment methods is that they should be applied before the biomechanical collapse of the head of the hip joint. The evidence of collapse is a symptom of a crescent moon, which can be identified during diagnosis.


Features of surgical methods of therapy

To determine which treatment should be prescribed, should a competent specialist. The choice of methods depends on how far the process of development of the disease has gone, from the age of a person and the characteristics of his organism. Today there are no drugs that can restore blood circulation in the damaged joint. In general, aseptic necrosis of the head of the femur is treated by surgical methods.

In the early stages, the main tasks of the operation are restoration of blood supply in the joint tissues and elimination of stagnation of venous blood. If the 2nd stage of the disease is diagnosed, the surgical intervention tasks are as follows:

  • to change the position of the head of the hip joint with respect to the acetabulum so as to eliminate the burden on the most affected part of the head;
  • improve blood flow in the joint and reduce blood pressure inside the bone;
  • to increase the mechanical strength of the affected parts of the head.
Prosthesis of the joint In the late stages of the disease during surgery, the damaged joint is replaced with a prosthesis

Several surgical methods are used to treat necrosis of the hip bone. Often shown to perform operations that restore blood flow in the joints:

  • decompression of the focus of osteonecrosis;
  • osteotomy( intervertebral and prone);
  • unvascularized osseous plastic;
  • Vascularized osseous plastic.

The osteonecrosis of the talus is treated with chondroplasty - surgery to replace the fractured part of the tibia. The tunneling method is also used( drilling of the affected area).

Endoprosthetics of the hip and knee joint are performed in 90% of patients with a diagnosis of "aseptic necrosis of the hip joint" if an operation is prescribed. This is the process of replacing a damaged joint with a transplant. With effective prosthetics, the patient's pain disappears and the amplitude of limb movement is fully restored. But there are some risks of complications and infection. In addition, if the surgeon incorrectly adjusted the prosthesis, he can quickly loose his tongue, and then a second operation is inevitable. With the correct operation, the implant replacement will take 12-15 years.

The main thing is to diagnose aseptic necrosis of the head of the hip joint or other joints as early as possible in order to do without surgical intervention. Conservative treatment, started in time and under the strict supervision of a specialist, gives good results. Any operation carries new problems and complications and requires a long rehabilitation.

A careless attitude toward one's health and untimely action in the presence of symptoms of a disease reduces the chances of recovery. It will take more effort and financial cost in order to restore the working capacity of the joints. Aseptic necrosis of the head of the femur.

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Aseptic necrosis of the head of the thigh is a very serious disease of the hip joint. It is the necrosis of the bone tissue of the femoral head. The necrosis occurs due to impaired blood circulation in the head of the femur.

Normally, bones always break down and regenerate bone blocks. When the blood flow is disturbed, inflow of oxygen and nutrients is disturbed. This causes disturbances in the recovery processes and their complete cessation. Bone tissue of the femoral head begins to degrade. Its mechanical properties gradually decrease. Under the influence of the load on the joint, the bone collapses( collapses) in the places of necrotic areas. Over time, the head of the femur is flattened. Normal joint work is difficult. At the final stage of aseptic necrosis of the femoral head develops osteoarthrosis of the hip joint.

Causes of aseptic bone necrosis

The main factors contributing to the development of aseptic necrosis of the femoral head include:

  • Hip joint trauma( hip fracture, hip dislocation, etc.);
  • Systematic small microtraumas and hip joint overloads( usually in athletes);
  • Effects of drugs( cytostatics, certain antibiotics and hormonal drugs for prolonged use);
  • Alcohol abuse;
  • Some diseases( systemic lupus erythematosus, Bechterew's disease, osteopenia, osteoporosis, rheumatoid arthritis, etc.);
  • Diseases accompanied by endothelial dysfunction( colds, inflammations).
  • Exposure to high pressure( from divers, miners).With improper decompression in the blood can form air bubbles, causing a blockage of blood vessels.

Stages of development of aseptic necrosis of the femoral head

I stage ( 6 months).The structure of the bone is changed insignificantly - no more than 10% is affected. Movement in the joint is not limited. Periodic pains arise that radiate into the inguinal region.

II stage ( 6 months).The stage of impression fracture. Cracks are observed on the surface of the femoral head. Foci of microcollapse or a crack in the trabecula zone are visible. It is struck 10-30%.Limited mobility of the joint( withdrawal and rotation).The pain is strong, permanent, irradiruyut in the groin.

III stage ( 3-6 months).Secondary arthrosis develops, the acetabulum is involved in the pathological process. The defeat of tissue increases to 30-50%.The mobility of the joint is sharply reduced. At this stage, the pain in the joint is strong and permanent.

IV stage .Complete destruction of the head of the femur. Constant pains in the region of the hip joint, muscles of the thigh and buttocks are atrophied, movements in the joint are minimal. The vicious thigh settings are formed.

Symptoms of aseptic bone necrosis

The main symptom is the pain in the hip joint area that occurs when walking, standing on the "aching" leg. With the development of aseptic necrosis, lameness appears, the mobility of the joint is impaired. In the late stages of pain is constant.

Diagnosis of hip joint necrosis

For the diagnosis, use an X-ray. But it allows you to accurately distinguish changes only if the duration of the disease is long enough. Most often, a magnetic resonance imaging( MRI) is used to diagnose aseptic necrosis. It allows you to detect even the smallest changes in the early stages of necrosis of the head of the femur.

Treatment of femoral neck necrosis

The choice of method of treatment depends on the specific case. Depending on the stage of the disease, age and other physiological characteristics of the patient. To date, there are no drugs that can restore blood flow in the head of the hip. Most often, with aseptic necrosis of the head of the femur, surgical methods of treatment are used.

Surgical treatment is of several types:

1. Operations to restore blood flow.

  • Femoral decompression. Through the neck of the hip, one or more channels are drilled into the head, where the blood flow is disturbed. Inside the canal, vessels begin to grow, which improves blood flow. The second positive effect is a decrease in intraosseous pressure and a reduction in pain in the joint.
  • Transplantation of an autograft from the fibula. Unlike the first operation, a segment of the fibula on the vascular pedicle is transplanted into the drilled hole. The transplant improves blood flow and strengthens the neck of the hip. This is a very complex and rare operation.

2. Endoprosthetics. Endoprosthetics is used in the late stages of necrosis of the head of the hip joint. A defective joint is replaced by a mechanical structure.

koksartroz.ru

Aseptic necrosis of the femoral head: causes and treatment

The hip joint is formed by the head of the femur and a special depression in the pelvic bones called the acetabulum. Normally the head of the femur is inserted into the acetabulum and fixed in it by ligaments.

The articular surface of the head has the shape of a hemisphere, the acetabulum is a recess with smooth rounded walls in the shape of a bowl. This form of contiguous surfaces allows the foot to make large amplitude movements in different directions.

Aseptic necrosis of the head of the hip joint - severe degenerative-dystrophic( associated with impaired blood circulation and metabolic processes) disease. Characterized by aseptic necrosis of the hip joint is the necrosis of the bone substance of the head of the femur in places where the greatest load is applied to it.

Gradually, the femoral head is destroyed, bone formations( osteophytes) form at its edges, the structure of the acetabulum changes and the deforming arthrosis of the hip joint is formed. Movement in the joint is severely limited until complete immobilization.

Necrosis is the process of necrosis of tissues, which can be caused by a variety of causes. The term "aseptic" means that necrosis in this disease occurs in sterile conditions, that is, without the participation of microorganisms.

Causes of

Causes that can cause aseptic necrosis of the head of the hip joint can be divided into four large groups:

  1. Vascular : changes in microcirculation( blood flow through the smallest vessels - the capillaries) and hemocoagulation( the ability of the blood to change the viscosity and coagulation).In this case, two options for the development of aseptic necrosis of the head of the hip joint are possible:
  2. In the first variant, blood circulation is disturbed in the bone tissue of the head of the femur and immediately leads to the development of foci of necrosis.
  3. In the second variant, circulatory disturbance leads to a disruption of cartilage nutrition. The cartilage at the same time loses its elastic properties and ceases to protect the underlying bone from excessive loads. The bone is damaged and foci of necrosis form in it.
  4. Mechano-functional , that is, associated with excessive load on the joint. Excessive loads can be connected both with the profession( electric and gas welders, parquet makers, drivers of heavy vehicles, etc.) and with displacement of the center of gravity when walking and performing work for a number of diseases such as osteochondrosis of the spine, for example, or dysplasia of the hipThe cause of excessive loads on the joint can also become overweight.
  5. Associated with metabolic disorders .
  6. Genetic factors of , such as gender, age, intensity of metabolic processes, rate of destruction of bone tissue and its neoplasm. Evidence of participation in the development of the disease may be that most often aseptic necrosis of the hip joint develops in men of working age.

It has now been established that none of the causes individually can cause disease. Only a certain combination of several causes and conditions can provoke necrosis of the head of the hip joint. Namely, local disturbance of microcirculation leads to a decrease in the ability of the articular cartilage and the underlying bone to repair. Their density and ability to withstand the load are reduced.

In such conditions, any damage to the cartilage or bones of the joint as a result of the load or external trauma aggravates their condition and provokes the appearance or progression of the process of necrosis of the bone tissue in the femoral head.

Symptoms of the disease

The course of the disease has certain stages, depending on the degree of damage to the structures of the hip joint. For each stage, almost the same symptoms are characteristic, but the nature of the symptoms and the degree of their expression varies.

Symptoms of aseptic necrosis of the hip are as follows: :

  • Pain;
  • Reduction of the amplitude of movements in the joint;
  • Reduces the burden on the leg and transfers most of the body weight to the leg healthy.

And now let's look at how the symptoms increase depending on the stage of the disease:

In the initial period of , the main symptom of the disease is pain. They appear suddenly. Some patients can remember not only the day, but also the hour of their first appearance. Localized pain in the region of the hip joint, can spread to the groin, the knee joint and the lumbosacral spine.

For the first few days, most patients can neither sit nor walk because of pain. Then there is some improvement in the condition: the pain appears periodically during physical exertion and disappears at rest. Then gradually their intensity and duration increase, there are pains at night.

The amplitude of the movements is preserved. There may be a slight atrophy( decrease) in the muscles of the thigh. Lameness is not present, the patient distributes weight of a body on two legs practically fifty-fifty.

In the second stage of the , the pain becomes permanent and intensified after physical exertion. The amplitude of movements in the diseased joint is slightly reduced. Atrophy of the muscles of the thigh is significant( the thigh decreases in circumference as compared to a healthy leg by 3-4 cm).The patient begins to take care of the aching legs and transfers most of the body to a healthy leg.

The third stage of pains are significant and intensified at the slightest load. The amplitude of movement in the patient joint sharply decreases, marked lameness is observed. Atrophy of the muscles of the hip is significant, the atrophy of the muscles of the shin begins. There may be a slight shortening of the sore leg.

In the fourth stage of , pain is severe. The gait is broken. The atrophy of the muscles of the thigh and lower leg is pronounced.

Diagnostics

A variety of methods are used to establish the diagnosis and determine the stage of the disease: X-ray examination, measurement of walking and support parameters, subgraphy, measurement of intraosseous pressure, MRI( magnetic resonance imaging) and others. The main diagnostic method is X-ray.

  • At the initial stage on the roentgenogram, areas of compaction or deflation of the bone tissue of the femoral head in places of necrosis are visible.
  • In the second stage, a flattening or a step-like deformation of the head appears in the pictures. This is due to the fact that the necrotic areas of the bone are squeezed and fail. The joint gap widened.
  • In the third stage on the roentgenogram, the contours of the femoral head become more and more uneven due to the progressive destruction of the bone, and due to the formation of marginal bone growths - osteophytes.
  • In the fourth stage, changes in the shape of the acetabulum are added to the described changes.

Treatment of

Treatment of hip joint necrosis can be conservative( without surgery) and prompt.

Conservative treatment of hip joint necrosis aimed at:

  • preventing or slowing the progression of the disease;
  • reduction or withdrawal of pain syndrome;
  • improved joint function.

Conservative treatment includes:

  • use of non-steroidal anti-inflammatory drugs and corticosteroids for pain relief, reduction of inflammation in the joint and normalization of metabolic processes;
  • therapeutic exercise;
  • physiotherapy: electrophoresis with novocaine, paraffin, ozocerite, ultrasound, diadynamic currents, balneotherapy, etc.
  • orthopedic treatment: orthopedic laying for the prevention of contractures etc;
  • massage to increase the contractile function of the muscles and restore their functions.

Surgical treatment of hip joint necrosis varies depending on the stage of the disease.

At the initial stage, the main objectives of the operation are:

  • restoration of blood circulation in the tissues of the hip joint;
  • elimination of venous stasis.

In the second stage, the operation objectives are different:

  • change the position of the head of the femur with respect to the acetabulum in such a way as to remove from the load the most damaged part of the head;
  • improved blood supply to the joint and decreased intraosseous blood pressure;
  • increase of mechanical strength of damaged head sections.

In the late stages of the disease, the replacement of the fractured joint with a prosthesis is used to restore the function of the lower limb.

bolsustav.ru

Aseptic necrosis of the femoral head

The bones of our skeleton consist of bone tissue, which, like most other tissues of the body, consists of living cells and contains blood vessels( arteries, capillaries and veins).If local blood supply is disturbed, the necrosis of the tissue or organ may develop, which can lead to serious problems. Disturbance of blood supply arises at blockage( thrombosis or embolism) of arteries that supply this area with blood. Especially often, tissue necrosis occurs in areas that are blood flowing from the pool of a single artery. To such "problem" areas is the head of the femur. If there is a violation of the blood supply of this area, a disease called aseptic necrosis( AS) of the femoral head occurs.

The head of the femur is supplied with a single artery that passes through the neck of the femur. In connection with the absence of collateral circulation, blood supply to the head of the femur is impaired when the blood flow is stopped in this artery. As a result, necrosis( necrosis) of the femoral head develops. Necrosis leads to a deterioration in the mechanical properties of bone tissue. Bone is not a "frozen" structure. In bone tissue, the bone beams are constantly being destroyed and regenerative processes are simultaneously taking place. The cessation of recovery processes due to a lack of oxygen and nutrients leads to a rapid deterioration of the mechanical properties of bone tissue. As a result, under the influence of mechanical loads, the necrotic portion of the bone collapses( shrinks).When the AN develops, the head of the femur changes: it flattenes in the region of maximum gravity. As a result, congruence( articulation) of articular surfaces in the hip joint is violated, which leads to an increase in internal load during joint operation and rapid wear of articular cartilage. The outcome of AN is the development of osteoarthrosis - a degenerative joint disease, accompanied by pain and a violation of its function.

Causes of

Many factors can lead to the development of the AS of the femoral head. Virtually any reason that contributes to the violation of blood flow in the artery of the femoral head, may be an impetus for the development of AN.So traumatic injuries of the hip joint can lead to a disruption of the blood supply to the femoral head as a result of mechanical damage or thrombosis of the artery. The most frequent injuries leading to the development of AN are fracture of the femoral neck and hip dislocation. AN develops in a few months, although the first clinical symptoms usually appear in patients much later( often 1.5-2 years after the trauma).

Some medicines may also contribute to the development of AS.Most often, the AN develops on the background of long-term use of high doses of glucocorticoid hormones for severe rheumatic diseases, bronchial asthma, etc. Treatment with short courses of hormonal drugs does not increase the risk of development of the AN head of the femur. It is also safe in this respect to single or double intraarticular or periarticular administration of hormonal drugs in the treatment of osteoarthritis, bursitis, tendinitis and other inflammatory diseases of the musculoskeletal system. A clear correlation between the excessive intake of alcohol and the frequency of development of the AN is traced. Alcohol contributes to damage to the blood vessels, which can lead to the development of ischemia of the head of the femur and the development of its necrosis. An increased frequency of development of AS is noted in individuals whose professional activity is associated with high pressure( divers, miners).If the decompression mode is incorrect, small air bubbles form in the blood, which can clog and damage blood vessels, including leading to a violation of blood flow along the artery of the femoral head.

Symptoms of

The first symptom of AN is pain in the hip joint area, which occurs when the body weight is transferred to the "aching" leg. Pain can spread to the inguinal, gluteal region, irradiate( give off) on the front surface of the thigh. With the progression of the disease, lameness and disruption of the function( mobility) of the joint appear. In the late stages of pain can persist and at rest, contribute to sleep disturbance.

Diagnosis

Diagnosis of AN begins with the study of patient complaints, medical history and physical examination. It is necessary to find out about the presence of chronic diseases, the intake of medicines, about occupational hazards, bad habits. Physical examination includes examination, palpation of the joint and the study of its function( angle of withdrawal, limb flexion, etc.).To clarify and confirm the diagnosis it is necessary to conduct additional laboratory and instrumental methods of examination.

Radiography

On the X-ray patterns, the AS region of the femoral head is determined, as a rule, with a sufficient duration of the disease. In the early stages of the disease, radiologic examination of pathological changes in the bone may not be determined, even though the patient may already be disturbed by severe pain in the joint. In the late stages of AN, osteoarthritis joins, and it can be difficult to determine which of these diseases causes the symptoms most commonly observed in the patient.

Radioisotope scanning( scintigraphy)

In the absence of pathological changes on radiographs, radioisotope scanning can be performed to clarify the diagnosis. With this technique, a medicinal product containing a radioactive pharmaceutical preparation is introduced into the patient's body. After a few hours with the help of a special gamma camera, radioactivity is recorded in the human body. In connection with the lack of blood flow in the head of the femur, this zone on the scintigram is presented as a "cold" spot, since it does not accumulate the radiopharmaceutical.

Magnetic resonance imaging

Currently, magnetic resonance imaging is the most commonly used method for the diagnosis of AS head of the femur. The principle of magnetic resonance imaging consists in obtaining images of tissues and organs of the body in the form of a series of slices with the help of electro-magnetic waves. This is the most informative and absolutely safe method of research. On magnetic resonance tomograms, even minor areas with a lack of blood flow can be detected, and in the earliest stages of the development of the disease.

Treatment of

Tactics of treatment with AS are determined by the stage of the disease and the severity of clinical symptoms. At present, the effectiveness of drugs aimed at restoring blood circulation in the artery of the femoral head has not been proven. While pain can be effectively controlled by the appointment of analgesic and anti-inflammatory drugs, surgical treatment is usually not required. Although in some cases, if the head of the hip does not collapse, the surgeon can offer an operation aimed at increasing the blood supply to the femoral head. There are several options for such operations.

Decompression of the femoral head

The principle of this operation is to drill one or more channels passing through the neck into the femoral head directly into the zone where there is no blood flow. This operation has two purposes: 1) to increase the blood supply of the ischemic region due to the growth of new blood vessels inside the drilled canal; 2) to reduce the intraosseous pressure inside the femoral head and thereby contribute to the reduction of pain in patients with AS.

This operation is performed through a very small incision on the lateral surface of the thigh under the control of an electron-optical converter( image intensifier).The EOP is a mobile digital X-ray machine that allows you to obtain bone images on the display screen directly during the operation. After decompression of the femoral head, the patient should use crutches for 6 weeks. This recommendation is due to the fact that reaming channels leads to a temporary decrease in the mechanical strength of the femoral neck, which increases the risk of fracture.

Hip Endoprosthetics

In the late stages of aseptic necrosis, degenerative joint damage develops in patients - osteoarthritis. In these cases, the endoprosthesis of the hip joint is shown to reduce the pain syndrome and improve the function of the joint.

ortopedov.ru

Aseptic necrosis of the head of the femur |femurhead.ru

Aseptic necrosis of the head of the femur is a serious degenerative-dystrophic bone disease due to a violation of the structure of bone tissue, microcirculation and fatty degeneration of the bone marrow.

There are 4 stages in its development:

  • I stage - the patient does not yet know about the upcoming disease. Microscopic changes in bone structure are not detected by all diagnostic methods. A subchondral osteonecrosis develops, in which the spongy substance of the femoral head is affected with unchanged cartilage. The zone of structural changes is no more than 10%.
  • II stage - there may be a feeling of slight discomfort in the affected area. There is an impression fracture, in which the surface of the head of the femur has cracks like a "cracked shell".In the loading zone, trabeculae, thin bone plates, have irregularly formed cracks or microcollapse foci. The zone of structural changes is no more than 10-30%.
  • III stage - when moving there are pains that do not disappear at rest. This is the stage of fragmentation, which is characterized by uneven contours of the head of the femur, a slight degree of collapse, the emergence of several foci of compaction or cystic degeneration. The articular space narrows or expands. The zone of structural changes is no more than 30-50%.
  • IV stage - acute pain even in the lying position, the joint is devoid of functionality. There is a dislocation or subluxation. The head is completely destroyed. The structure of the trabeculae is dissolved or compacted, irregularly shaped cracks. Internal or external edges of the acetabulum are displaced. The articular space is narrowed or has disappeared. The zone of structural changes is 50-80%.

According to the observations conducted in our center, we noted the duration of each stage: the first stage proceeds 6 months, the second stage - 6 months, the third stage - 3-6 months with the subsequent transition to the IV stage.

ANGBC is caused by various factors. If you are exposed to one of the listed effects, you are at risk:

  • Diseases( osteopenia, osteoporosis, lupus erythematosus, Bechterew's disease, rheumatoid arthritis, sickle cell anemia, ischemic heart disease, hypertension, hypercholesterolemia, osteosynthesis,screws, etc.);
  • The toxic effect of such drugs as glucocorticoids, steroids and cytotoxic agents, antibiotics;Alcohol intoxication, smoking.

We have compiled a detailed description of ANGSK's symptoms in order to spread the information among as many of our readers as possible, because the sooner you contact our center, the sooner we will be able to help. People who are at risk should also know and undergo ANGBC diagnosis, which allows to identify the disease in the preclinical stage and, thus, to prevent serious cases of the disease.

Symptoms of aseptic necrosis of the femoral head

At this time, aseptic necrosis of the head of the femur is a fairly common disease. This is due to a significant change in lifestyle and nutrition. Also, the expansion of the diagnostic capabilities of modern equipment( MRI, CT, heart function analyzer) allows us to identify the early stages of ANGBC, which previously could not be diagnosed. In modern conditions, it is necessary to inform the population about the symptoms of ANGBC, which is at risk.

As a rule, the doctor only visits the III or IV stage of the disease, when to improve the patient's condition it will take much more effort and time than when seeking help at the initial stage.

Be attentive to your joints and consult a doctor immediately if you find the following symptoms of aseptic necrosis:

  • You have a short, episodic pain in the hip joint region, the groin area. The pain can irradiate into the knee, sacrum, waist.
  • Appearance of "starting" pain at the beginning of movement, lifting from the bed.

In the future the symptoms appear avalanche-like:

  • You feel a constant pain in the hip joint area. The pain does not leave you in a state of movement: when walking, squatting or climbing and practically does not leave you even at rest. In especially severe cases, pain does not even allow you to fall asleep.
  • It is difficult for you to step on a painful leg, as a result of it there is lameness.
  • The leg loses its mobility: it is difficult to bend it or move it aside.
  • On the aching leg muscles atrophy quite quickly, which creates the effect of losing weight limbs separately from the rest of the body.
  • If the body is lying flat, you can see that the sick leg has become shorter than the healthy leg.

If you observe the described symptoms of ANGBC, do not self-medicate and wait until the disease reaches its climax - the joint will change its shape, movement will become possible only with additional support, help from other people. Contact our Center, and we will conduct a professional diagnosis that will identify the stage of the disease, select individual treatment and give hope for the restoration of the joint.

Early diagnosis of aseptic necrosis of the femoral head - the ability to prevent serious disease

A doctor's appointment with aseptic necrosis usually occurs already in the later stages, when pain is present and the limb functionality is reduced. The first stages often go unnoticed, which is why our specialists carry out an extensive examination to identify early stages of aseptic necrosis of the femoral head with the slightest discomfort in the hip.

Today, the advanced approach is a comprehensive diagnostic approach. We disseminate information about the causes of the occurrence of ANGBC and suggest that patients at risk should undergo a preventive comprehensive examination aimed at preventing the development of the disease and providing treatment at the initial stage. The components of the complex diagnostics are: examination on the Scriphax screening analyzer, review radiography with the subsequent study of the images in the Analiser + program, ultrasound densitometry, x-ray dual-energy densitometry, three-phase soft tissue and skeleton scintigraphy, study of microcirculation at the hip joint locilocalization), traditional and in-depth studies of blood and urine.

The main diagnostic methods of ANGBK

Diagnosis of aseptic necrosis of the head of the femur includes the following most common methods:

  • Radiographic survey of pelvic bones in three projections( on the back, on the abdomen, laying according to Launstein).This is the oldest, most common method.
  • Magnetic resonance imaging. This method allows to see the appearance of aseptic necrosis in the initial stages( edema of the bone marrow).
  • Three-phase scintigraphy of soft tissue and skeleton serves to assess blood flow, changes in bone tissue and to exclude the presence of malignant formations or metastasis.

Additional Diagnostic Methods of ANGBC

After the initial determination of the patient's condition, the problem arises of choosing the required method of treatment, and the following diagnostic methods are required:

  • X-ray dual-energy densitometry of the femoral head allows to determine the density of bone tissue. This is especially true for patients taking glucocorticoids or suffering from a decrease in the function of the sexual glands.
  • Ultrasonic densitometry serves to determine the state of bone tissue in terms of the speed of passage through it of ultrasonic waves and the degree of their absorption by tissue. The method is absolutely safe, since it has no radiation effect on the body.
  • The processing of X-ray images in the "Analizer +" program gives an opportunity to see the initial signs of the disease, when the changes in the bone tissue are just beginning.
  • Express diagnostics of diseases and changes in internal organs at the screening analyzer "Screening" The basis for the theory of information function of the heart and technology for the analysis of electrocardiograms, allows to identify diseases that can affect the development of joint diseases. Thus, it is possible to identify coronary heart disease, hypertension, diabetes mellitus, cholelithiasis, urolithiasis and peptic ulcer disease, chronic gastritis( gastroduodenitis), chronic cholecystitis and latent oncological processes. The special value of the diagnostic system "Screening" - in the possibility of detecting hidden processes of cell degeneration in the patient's body, and indicating their localization. In our Center, a special signal was also identified, which corresponds to ANGBC at the preclinical stage.
  • Traditional and in-depth blood tests give an idea of ​​the overall health and associated diseases: a general blood test with a leukocyte formula;determination of the blood group and Rh factor, "hospital complex";biochemical blood test and determination of the level of creatinine, total cholesterol, LDL, HDL, VLDL and glucose;complex blood test for the content of vitamin D and metabolites of vitamin D, total and ionized calcium( Ca ++), magnesium, inorganic phosphorus, anti-streptolysin-O( ASLO), C-reactive protein, rheumatoid factor, uric acid, homocysteine, procalcitonin, parathyroid hormone, calcitonin, osteocalcitonin B-cross laps, prothrombin time, prothrombin index;serological examination of blood for the detection of antigens and antibodies to chlamydia, mycoplasmas, ureaplasmas, toxoplasma, cytomegalovirus, herpes simplex virus, Epstein-Barr virus, systemic lupus erythematosus, genetic determinants.
  • Urinalysis provides an additional study of the concentration of calcium in daily urine and DPID in a single urine.

Non-surgical method for the treatment of aseptic necrosis of the femoral head

We use a unique non-surgical method based on progressive discoveries in the field of medicine. Not so long ago, a unique feature of the bone was discovered, thanks to which it is the only organ, if damaged, replacing its defects with a non-connective-woven scar, and with a new full bone tissue. It has also been found that the head of the femur has a great capacity for regeneration and plasticity. In addition, in their medical practices, we rely on Wolff's law, according to which a change in the functional load on the bone causes its internal restructuring, which is adaptive in nature. This means that the bone is able to recover without surgery with properly organized treatment, thus, it is possible to restore the functionality of the joint.

The treatment activities at our center include the following:

  • Redistribution of the load from the necrosis-affected sector of the GAB and compliance with the orthopedic regime with crutches. Reducing the load makes it possible not to injure the site affected by necrosis, and to start recovery processes in bone tissue.
  • Ingestion of medications. Medicines for each patient are selected individually, according to the peculiarities of his condition.
  • Electrostimulation of acupuncture points via phytoapplicators using therapeutic apparatus NS-5, Osteon-1.Therapeutic apparatuses have two electrodes that supply an electrical signal with a predetermined frequency and amplitude, providing compensation for the deficit of the external load. The device for the treatment of necrosis of the head of the femur is a medical device specially designed for the complex treatment of this disease. Due to modern technical design, the device creates various electrical signals - low-frequency pulses and six types of special frequencies of medium frequency. At the same time, through the acupuncture points, active ingredients from the skin applicators are passed into the human body, which pass through the skin and reach the locus of the disease, carrying out the original treatment.
  • Segmental and periosteal massage. Individual parts of the body are massaged, and also point impact on certain parts of the bone.
  • Fitovannye at a temperature of 37-38 ° C.They serve as a fortifying and beneficial agent for the nervous system.
  • Daily exercise sessions. Exercises are conducted according to the author's method and are selected individually.

An internal electrochemical environment is created in the head of the femoral bone in the course of treatment of ANGBC. It facilitates the restoration of the disturbed microcirculation and the active removal of the products of the metabolism destroyed by the disease, stimulates the division and differentiation of bone cells gradually replacing the bone defect. All the needs of the joint in the necessary mineral and nutrients for the regeneration of bone tissue are satisfied by their constant inflow through the skin, provided with the help of special devices and applicators with biologically active substances, and also by ingesting highly effective drugs and full nutrition.

Already in the first stages of therapy, the patient notes improvement in general health, the disappearance of pain and an increase in the volume of movements in the hip joint. The first successes inspire optimism and give the necessary positive impulse to recovery. Gradual restoration of the joint, its adaptation to the load, improvement of the motor function contribute to the return of the normal gait and the former muscle strength, the social activation of the patient.

The effectiveness of treatment is assessed by the disappearance of subjective symptoms of the disease and by objective research methods. Every three months, a control radiograph of the hip joint and an analysis of changes in the structure of the head of the femur are carried out. If necessary, blood and urine tests are also performed to assess the dynamics of mineral, carbohydrate, fat metabolism, bone formation and resorption parameters.

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