| New bone graft |
As is probably the case with most that initially come to this site, I was hoping to read about others with similar experiences with AVN. It's hard for me to believe that I've been stricken with this ailment, and even harder to believe how it came about. As I read about so many others that used steroids that resulted in their condition, I too believe that they caused mine. The problem with my case is that it was most likely caused by a one-time prescribed "dose pak" for inner ear inflammation. While I was at the tail end of the prescription, I had a severe reaction and had to go the ER as I was in tremendous pain in all of my joints. My hips were so painful that I couldn't walk for four days. All that they could determine at the time is that is was a reaction to the methyprednisalone that I was prescribed. Naturally they told me that I should be OK once the steroids were out of my system, but about 18 months later, I started having my hip pain. My Doctor questioned the steroid connection, but also checked my medical records and did a little research and said chances were pretty good that it did cause the AVN. Yes, he did ask me if I drink and I said that I do, but not enough to be the culprit here. Steroids may do some really good things for people, but if you don't really need them, NEVER take them.
Well, now that I've been diagnosed with bilateral AVN with an asymptomatic left hip but a chronic right hip, my surgery is scheduled for June 18th. My Doc misdiagnosed initially and then went conservative and basically wasted 4 months of my time having me on crutches most of the time. My right hip is staged at a Ficat IIb and the femoral head in intact. As my Doc is young and aggressive, he feels pretty cocky about actually reversing my AVN. He makes no promises, but says his success rate is 85%+ in stage II and under and he uses a new technique that no one is talking about here. He utilizes a tool call the Xream from Wright Medical Technologies which is inserted into the femoral head after it has been drilled. Once inside, the tool expands at the end and further debrides the necrotic bone lesion. Kind of like a roto-rooter, I guess. Then, after irrigating out all of the bone matter, he utilizes a new triphasic bone graft called "Pro-dense", also from Wright Medical. Having gone to their website and reviewing all of the clinical trial information and white papers, this stuff appears to to showing tremendous success in allowing the femoral head or other bones to grow new dense bone faster than with other previous grafts. It hardens quickly when placed into the created defect. Once placed inside, it provides support and ultimately creates a scaffolding for the new bone to grow and absorb the grafting material over time. At this point all I can do is hope it works. If anyone has had this technique used on them, please reply back and let everyone know of your experience. Otherwise, I will let you all know how I progress after the procedure and whether it is successful. If it is, my left hip will be done down the road. Good luck to everyone else going down the same path.


New bone graft / Follow up
Based upon the number of responses that I've seen on this site, everyone must realize what an elite group we are to be afflicted with this wonderful ailment. Facetiousness aside, I'm responding to my own post 48 hours after my surgery.
Having had my core decompression on Thursday the 18th, 48 hours ago, I'm just now fully recovering from the anesteshia. Quit taking my pain meds after last night just to see what I'm dealing with. The Doc gave me some good stuff too, Oxycontin and Percocet. Guess If I don't need them now I can save them for a rainy day. There have been plenty of painful rainy days since the AVN was diagnosed and prior to that as well. The procedure went well according to my Doc. He drilled into the femoral head and them put a surgical tool in place that expanded and removed the necrotic bone. Since the entire femoral head was involved according to him, he drilled dead center and removed quite a bit of bone. He said that to make sure that he got all the bad bone that he removed enough until he started getting into the good part of the bone as well. That way, healing has a better chance of regenerating new bone. Something that he did that was new from everything that I had previously read about this new bone graft, is that he took blood before the procedure and spun it out and removed certain components from the blood and mixed it in with the graft when it was placed into the created void in the femoral head. This was to promote faster bone growth and increase the chances for new vascularization. This all sounds great, huh? Got to admit, with all that I've read about core decompressions and the success rates, my Doc is real cocky about his success rates in Ficat Stage II and earlier femoral heads. As I go through the recovery process, I'll let you know how I do. My Doc has told me to plan on approx 6 to 8 weeks totally NWB. After that he'll ween me back to partial WB. There will be some PT along the way, but I'm ready for that. My right leg has atrophied quite a bit since last December when the symptoms started and the use of my leg was compromised. More to come.......
JackT, excellent posts with
JackT, excellent posts with some great information. I am very interested in investigating any and all procedures that can be possible treatments for AVN. I will definitely add researching the Xream and other items you mentioned.
Still Healing
Joel:
Glad to hear that you have had a good experience with your CD's. Have read so much about those that didn't work and were revised to THA, that I was certainly concerned about my own odds. My Doc seems to be pretty much up to speed on AVN and that it needs to be approached aggressively. So many posts that I read are from those with AVN that have Docs that make them wait and go through hell before they get any satisfaction. It's just been over three weeks for me and I believe that I'm healing as I should. Hope that the bone graft that was used is working well and will truly replace the necrotic bone that was removed. If this procedure actually reverses the AVN that would be wonderful, but I believe that the Docs would be happy just seeing me get a few more years out of my own hip. Since I also have AVN bilaterally, it's just a matter of time before the left hip gets done too. By then, I'll know how things went and whether I WANT to have the other one done. Look forward to chatting and seeing how you are doing as well, as I'll be going through the same steps you already have.
is it just me or...
Do all ortho docs have a cocky attitude? Seems like they are increasingly getting more cocky by the day. I need to find a good OS here in san diego to deal with my unending plight of avn. Now its in my femur and tiba and the MRI is HORRENDOUS. any ideas???