WHAT IS AVASCULAR NECROSIS OF HIP?
Avascular necrosis is a localized bone decay of top one –third part of head of femur as a result of trauma or other cause like drug side effects. Necrosis of head of femur result pain in joint, groin and front of thigh and reduce motion. It is also called aseptic necrosis or osteonecrosis.
Cause of Avascular Necrosis of Hip
- Trauma- fracture neck femur
- Chronic corticosteroid therapy (taking steroid for some other disease for longer time)
- Alcoholism
- Smoking
- SLE
- Hyperlipidemics –increase level of lipids
- HIV
- Diabetics
It may developed due to femoral neck fracture or it may also happen if artery supply to head of femur is occluded due to embolism.
Prevention : Avascular Necrosis of Hip
- Trauma and some drug reactions are causative factor for AVN. Therefore drug should be used very carefully to avoid this very unpleasant side effect
- Alcohol and smoking are precursor factor so should be avoided
- Early diagnosis very help full to control disease
- Optimal treatment is key for success.
Prognosis : Avascular Necrosis of Hip
-- AVN of Hip prognosis is poor
- As soon as diagnosis is confirm, weight bearing on affected leg must be reduced
- Joint mobility should be maintained
- Early MRI scan prove good tool of AVN diagnosis
Avascular necrosis (AVN) Physiotherapy Treatment
Also known as osteonecrosis, is a condition where the blood supply to the head of the femur (thighbone) is disrupted, leading to the death of bone tissue. Physiotherapy can play a crucial role in the treatment of avascular necrosis of the hip, focusing on pain management, improving joint function, and preventing further complications. Here are some physiotherapy interventions commonly used in the treatment of AVN of the hip
- Pain Management:
- Modalities such as ice or heat packs may be used to alleviate pain and reduce inflammation.
- Transcutaneous Electrical Nerve Stimulation (TENS) can be applied to help control pain.
- Range of Motion (ROM) Exercises:
- Gentle and controlled exercises are employed to maintain or improve the range of motion in the hip joint without putting excessive stress on the affected area.
- Passive range of motion exercises may be initially used, with progression to active and resistive exercises as tolerated.
- Strengthening Exercises:
- Targeted strengthening exercises for the muscles around the hip joint, including the quadriceps, hamstrings, and hip abductors/adductors, can help improve joint stability.
- Isometric exercises may be recommended initially, followed by progressive resistance exercises.
- Weight-Bearing Exercises:
- Gradual weight-bearing exercises may be introduced to improve the load-bearing capacity of the affected hip while minimizing stress on the compromised joint.
- Aquatic therapy may be considered as a low-impact option for weight-bearing exercises.
- Functional Training:
- Functional activities such as walking, stair climbing, and balance exercises are integrated into the rehabilitation program to improve overall mobility and functional independence.
- Joint Protection Techniques:
- Education on joint protection techniques is provided to minimize stress on the affected hip during daily activities.
- Assistive devices like canes or crutches may be recommended to reduce weight-bearing on the affected side.
- Posture and Gait Training:
- Correction of posture and gait abnormalities to ensure optimal biomechanics and reduce stress on the hip joint.
- Patient Education:
- Patients are educated about their condition, the importance of adherence to prescribed exercises, and lifestyle modifications to manage symptoms effectively.
- Guidance on pain management strategies, including the use of assistive devices and activity modification, is provided.