Aseptic (avascular) necrosis: causes, symptoms and ways of treatment

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Bone needs nutrition, which gives her blood. If blood circulation is disturbed, a pathological process starts, which ends with the necrosis of a part of the bone tissue. This process is called necrosis, and with the progression of it it can be all destroyed.

Most often affects the head of the femur, knees, ankles and shoulders. The process of the disease starts as a result of trauma, thrombosis or after the disease. In healthy people, the risk of bone loss is extremely low. Dying of the head of the femur is most often recorded in men, and the same problems with the knee joint - in women.

Danger of necrosisin that it makes the bones very fragile, the joints crumble, even with a weak load on them. Usually such changes are irreversible, and in very rare cases regeneration of skeletal tissue occurs.

The necrosis of tissue occurs not through the fault of bacteria, so necrosis is called"Aseptic"i.e. under sterile conditions, and the term"Avascular"reflects its other specificity: without blood supply.

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Content

  • 1Stages of necrosis
  • 2Aseptic necrosis of the femoral head
  • 3Symptoms
  • 4Necrosis of the hip and knee joint
  • 5Necrosis of humerus and talus, Mouche disease
  • 6Treatment with aseptic necrosis
  • 7Prevention

Stages of necrosis

The disease develops during 4 stages:

  1. Mild pain, the hip apparatus functions well, the structure of the bone tissue is changed little.
  2. On the head of the joint begins to form dead spots, cracks, movements are made with difficulty, the pain is always felt.
  3. Movement of the hip skeleton is severely limited, secondary arthrosis develops. The necrosis of the tissue expands.
  4. There is a destruction of the head of the femoral joint, muscle fibers are atrophied in the buttocks and the injured thigh. Pain becomes unbearable.

Aseptic necrosis of the femoral head

Among others, the pelvic apparatus is considered a problematic part of the skeleton, in which, as the blood flow slows down, aseptic necrosis of the femoral head may occurreason:

  • thrombosis;
  • abundant intake of antibiotics;
  • many times repeated injuries;
  • frequent intoxication with alcohol or corticosteroids;
  • diseases of osteoporosis and rheumatoid arthritis, colds and inflammations.
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The same causes most often cause the disease and throughout the skeleton.

If you do not pay attention to dangerous symptoms in time, arthrosis with this kind of lesion goes deep, you have to resort to osteotomy (excision of dead areas) and endoprosthetics.

Symptoms

At different stages, the symptoms of the disease are similar, but their intensity varies:

  • pain in the affected area;
  • atrophied soft tissues of the thigh;
  • limited movement of the joint;
  • avoiding advancing on a sick limb.

Aseptic necrosis manifests itself at different stages as followssymptoms:

  1. In the first stage, the pain manifests suddenly, is localized in the groin, in the region of the hip joint, and the knee is given back. Then comes a period of slight improvement, when the pain manifests only when the load on the joint. After a short remission, the intensity of pain increases. At this time, a little decrease, atrophic muscles of the thigh, but the lameness is not there, the weight is distributed to both extremities.
  2. In the second stage, soreness is always felt, the affected hip becomes less healthy in the girth by a few centimeters. Most of the body weight is transferred to a healthy limb.
  3. The third stage is characterized by severe lameness, significant pain, and atrophy extends to the muscles of the shins. Unhealthy leg can become shorter.
  4. The fourth stage is characterized by a completely disturbed gait and a strong atrophy of the entire leg. Avascular necrosis of the femoral head completely destroys the joint, which leads to disability and requires prosthetics.

Necrosis of the hip and knee joint

The hip joint is the largest spherical articulation of the skeleton, it consists of the joint cavity and the head moving in it. Blood supply occurs with the help of only one femoral artery.

With thrombosis or atrophy of the femoral artery, blood poorly feeds this zone, andbone tissue begins to suffer from the lack of nutrients and oxygen. Regeneration of bone mass stops, and the joint begins to collapse. Avascular necrosis is accompanied by severe pain in the affected area.

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Problems with the knee joint usually begin after trauma, as a result of which the blood supply of this zone ceases or is disturbed. The condyles (bony projections, to which the muscles are attached), which make up the knee joint, suffer first of all.

The disease of these bones does not allow to bend and unbend the lower limbs, as a result of which a person becomes an invalid.

Non-steroidal anti-inflammatory drugshelp relieve pain and inflammation in the affected areas, but self-medication here does not help - with the slightest suspicion, you need to urgently consult a doctor. It is likely that surgery will be prescribed - bone grafting or joint replacement.

Necrosis of humerus and talus, Mouche disease

First, there are pains in the shoulder joint, it becomes inactive, then the muscles are atrophied, and deforming arthrosis begins. Treatment of aseptic necrosis of the talus is most oftenarthroplasty of the upper limb joint.

Treatment with aseptic necrosis

The tactic of treatment consists primarily in restoring blood circulation in the joint and resuming the regeneration of bone tissue.

Medicines and methods of healing, prescribed in the treatment of aseptic necrosis:

  1. Non-steroidal anti-inflammatory drugs - indomethacin, diclofenac, piroxicam, butadione and related agents, which reduce pain in the inguinal zone and in the leg. They relieve muscle spasm.
  2. Vasodilators - theodical, trental - resume blood circulation, cause the tissues of the head of the bone to regenerate due to good blood supply. Femoral artery is restored, spasmodic manifestations in small blood vessels are removed. These remedies are practically harmless, but you need to be careful when you suspect a heart attack.
  3. Novocaine blockages of the waist.
  4. Massage in the affected area to improve blood flow.
  5. Hirudotherapy - treatment with medical leeches.
  6. Preparations for stimulation of bone mass formation - calcium preparations in combination with vitamin D (vitamin improves the absorption of calcium).
  7. Calcitonins - drugs derived from thyroid hormones, help regenerate bone cells, eliminate pain in the necrotic areas of the skeleton. Stop the leaching of calcium from the skeleton.
  8. Chondroprotectors, feeding and restoring cartilaginous tissue in the joints, are glucosamine and chondroitin sulfate.
  9. Mandatory use of a walking stick or stick to reduce the load on the joint.
  10. Physiotherapy.
  11. Endoprosthetics with titanium and zirconium prostheses.
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Prevention

As a preventive measure for this type of disease should be recommendedhealthy lifestyle.

To avoid thrombosis in the femoral artery, you need to eat right - without excessively cholesterol dishes, fatty, salty and smoked foods.

Alsoyou can not move too much, because that's why there are disorders in the circulation of pelvic bones.Alcohol is harmful for all organs- and in the causes of this disease, he is not in the last place.

Adhere to the principles of a healthy life, on time contact a doctor and you do not have to think about how to cure the disease of the head of the femur, and you will be able to avoid many problems with your organism.

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