MRI showed stage 1 AVN in both hips in different angles. Do I need hip replacement?

Hello,

Welcome to icliniq.com.

AVN (avascular necrosis) of the hip is usually due to a number of causes. Prolonged steroid intake is one of them. The treatment of AVN hips ranges from rest, core decompression and eventually hip replacement. Since you have had stage 1 and 2 in your respective hips, core decompression was a good choice. This procedure involves drilling one larger hole or several smaller holes into the femoral head to relieve pressure in the bone and create channels for new blood vessels to nourish the affected areas of the hip. When osteonecrosis of the hip is diagnosed early, core decompression is sometimes successful in preventing the collapse of the femoral head and the development of arthritis. Core decompression is often combined with bone and cartilage grafting to help regenerate healthy bone and support cartilage at the hip joint. A bone graft is a healthy bone tissue that is transplanted to an area of the body where it is needed. The tissue may be taken from a donor (allograft) or from another bone in your body (autograft). Core decompression prevents osteonecrosis from progressing to severe arthritis and the need for hip replacement in some cases. Your x-ray does not appear too bad and I am hopeful that core decompression could help in reversal.

I hope this helps.

Hello,

Welcome back to icliniq.com.

It is not very common for two reasons. Firstly, not everyone gets an MRI to just see how much they have recovered. The MRIs are usually done in symptomatic patients who present with complaints. Furthermore, usually, people do not get themselves diagnosed and treated at an early stage. Many of them wait till the final stage and get the replacement done. Please let me know in case of any other queries or concerns.

Thank you.

Hello,

Welcome back to icliniq.com.

I have seen the reports (attachment removed to protect the patient's identity). Is this the MRI before the procedure or after the procedure? It is never an issue to answer queries. Please do not feel that you are bugging me in any way.

Thank you.

Hello,

Welcome back to icliniq.com.

It is what you mentioned in the message that is stage 1 and 2 respectively. Getting an MRI done every three months would help in getting updates on its progression or regression. I would recommend starting bisphosphonates. They have been shown to reverse the progression of AVN. Please let me know in case of any other concerns I could even share a few research papers with you which mention the reversal of AVN using bisphosphonates. I am unable to attach them here. You could even read them online.

Thank you.

Hello,

Welcome back to icliniq.com.

Thank you for the message. I am glad to know that you have so many doctors around you. Hence I am confident that you are in very safe hands. Having a cocktail of these regimens is the best option one could have. As stated in the literature shared with you via icliniq, there are patients who have shown recovery with core decompression and bisphosphonates. These have been mainly in the early stages of AVN. This has been true in my practice too. But there are always exceptions. I am hopeful for the same outcome in your case considering the early stage of AVN.

Thank you.

Hello,

Welcome back to icliniq.com.

I wish you all the very best and a speedy recovery. Do feel free to get in touch in case of any other queries or concerns. Stay positive

Thank you.