Hip replacement surgery India
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Avascular necrosis
Avascular necrosis (also osteonecrosis, bone infarction, aseptic necrosis, ischemic bone necrosis, and AVN) is a disease where there is cellular death (necrosis) of bone components due to interruption of the blood supply. Without blood, the bony tissue dies and bone collapses. If avascular necrosis involves the ends of bones in a joint, it often leads to destruction of the joint surfaces. While AVN can affect any bone, it most commonly affects the top of the thigh bone ( femoral head). Hip joint destruction is the final result of untreated AVN of the head of the femur.
Causes
Very often there are no known causes. Known causes include the following
1.Alcoholism
2.Steroid therapy
3.Rheumatoid arthritis & SLE
4.Post trauma
5.Sickle cell disease
6.Caisson's disease
7.Hypertension, thrombosis, embolism
Presentation
The disease is silent to begin with. Later as the disease advances, it manifests with hip pain. To begin with the pain comes on during walking. Later it is present even at rest and finally, as the joint is destroyed completely, the patient is crippled due to pain. It affects adults in the age group 20-60 years. In 30- 70 percent of cases, both hips are affected.
Diagnosis
When you develop hip pain lasting for more than a month, consult your doctor, particularly if you have any risk factors above. A high degree of suspicion is needed to pick up early cases. MRI is the best modality for an early diagnosis. When an adult with a risk factor presents with hip pain for more than 2 weeks, an MRI can be done. This may pick up the disease in its early stages itself. X rays don't show the disease until a later stage.
The ideal treatment depends on the extent and stage of the disease.
Treatment
Treatment is necessary as if left untreated, most patients will be left with continuous hip pain and lack of mobility. Non operative treatment fails in 85 % of cases. Some form of surgical intervention is necessary.
Early stages of the disease can be treated with core decompression. This relieves the pressure on the blood supply and can bring in fresh blood supply. It succeeds in 60- 85 % of early cases. It is not useful in late cases when bony collapse has already occurred.
The addition of stem cells to a core decompression improves results in carefully selected cases. This biologic approach with bone forming stem cells to regenerate living bone is an additional armamentarium to the Orthopedic surgeon. Bone forming stem cells are derived from the patient's own pelvis and injected into the diseased area.
In late cases with bony collapse and joint destruction arthroplasty or joint replacement is necessary.
Hip replacement surgery is very valuable in those cases with joint destruction. A hip resurfacing can be done in early cases. If there is more bone loss in advanced cases, other options are better.
Short stem hip replacements like the Proxima Hip
Silent hip
,
METHA hip 
BMHR
are valuable replacement or arthroplasty options in treatment of Avascular necrosis with large cysts.
See how an young Indian lady got a new lease of life from a short stem hip replacment in this video. http://www.youtube.com/watch?v=IAolaKakh2M