| Osteonecrosis is a condition due arising from a | | | | hip replacement can still be done at a later |
| diminution of blood supply to bone. It affects most | | | | date.Treatment in the early stages is controversial |
| importantly the upper end of the femur. If left | | | | and there are no clear guidleines.Prolonged bedrest |
| untreated it progresses to bony collapse and arthritis. | | | | and crutch walking have not been shown to relieve |
| The causes are many like alcohol abuse, steroid | | | | pain or halt progression of the disease. |
| intake, Caisson's disease, Gaucher's disease.The | | | | Core decompression does ameliorate symptoms. It |
| patient can experience sudden pain in the hips which | | | | is minimally invasive and does not involve a |
| radiates to the knee and can be confused for knee | | | | replacement. If it fails then a replacement is possible |
| pain.Gait is painful. | | | | at a later date. |
| In early cases, x- rays are negative and MR scans | | | | Vascularised fiblar graft is done with the help of a |
| are diagnostic.Treatment in Late casesTreatment in | | | | microvascular surgeon.The author trained with |
| late cases is by an Hip replacement either total if | | | | eminent Hip experts in Cambridge, Manchester and |
| bony destruction is extensive. A partial or total | | | | Livepool. He performs Hip replacements, Hip |
| surface hip replacement is done if destruction is | | | | resurfacing, Osteotomies, Fracture fixation, Core |
| confined to the surface cartilage alone. Since it occurs | | | | decompression, Birmingham replacements at |
| in young individuals, a Surface Hip replacement is a | | | | Venkataeswara hospital. |
| better option as it conserves bony stock and a total | | | | |