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Aseptic necrosis of a bone


The aseptic necrosis of a bone,  also called ischemic necrosis of a bone, is a state which arises at disturbance of vascularization of a bone. The bone, as well as any other living tissue, demands food, and at the blood circulation termination it dies off. At further progressing of a state the bone completely collapses.
The aseptic necrosis most often develops in a femur.  Quite often also it is localized in a humeral bone, a forearm, an anklebone and in knees.
Most of the diseased are in working-age (from 20 to 50 years). For healthy people the risk of development of an aseptic necrosis is small.

Reasons of an aseptic necrosis of a bone:

In most cases are the reason of its emergence traumatized. The possible reasons of an aseptic necrosis of a bone include:
1. Dislocation or fracture of a femur. At this type of damage inflow of blood to a bone can be broken that leads to development of an aseptic necrosis. The aseptic necrosis of a femur is diagnosed more than for 20% of people who got hip dislocation.
2. Long reception of corticosteroids. Prolonged use of these drugs is connected from 35% of all cases of an aseptic necrosis of a bone of not traumatic character. Though the reasons of it are not absolutely clear, there are researches indicating influence of corticosteroids on increase in adjournment of lipids in a wall of vessels. Thus, the gleam of vessels is narrowed, and inflow of blood to a bone sharply decreases.
3. Excessive alcohol intake. Also, as well as corticosteroids, excessive alcohol intake can cause fatty deposits in blood vessels that results in  deficit of inflow of blood to a bone.
4. Fibrinferments, inflammation and injury of arteries. All this can block bone vascularization.
Other conditions connected with not traumatic aseptic necrosis of a bone include:
1. A disease to Gosha and other hereditary metabolic frustration at which fats collect in bodies in the increased quantity.
2. Drepanocytic anemia.
3. Pancreatitis (pancreas inflammation).
4. HIV infection.
5. Radiation therapy or chemotherapy.
6. Autoimmune diseases.
7. A compressed-air disease - a state which arises when the organism is exposed to sudden decrease in surrounding pressure.

Symptoms of an aseptic necrosis of a bone:

At early stages, the aseptic necrosis of a bone usually does not cause symptoms, however in process of progressing of a disease there are painful feelings. In the beginning the patient complains of pain only when pressing on an affected area of a bone, in an effect pain becomes a constant. If the disease progresses, the bone and the fabrics surrounding it is surprised, the patient feels severe pain which considerably complicates the movements in a joint. The period between the first symptoms and a full necrosis of a bone tissue can vary from several months to one year and more.

Асептический некроз головки бедренной кости

Aseptic necrosis of a head of a femur

Treatment of an aseptic necrosis of a bone:

The purposes of treatment of an aseptic necrosis ensuring function of the affected joint, a stop of further progressing of bone pathology and reduction of pain is.
Results of treatment will depend on a number of factors, including:
- age of the patient;
- disease stage;
- arrangement and volume of bone damages;
- the reason which caused an aseptic necrosis.
If the reason of an aseptic necrosis in a specific case is authentically known, treatment will be directed first of all to stopping of the main pathology.  For example, if the aseptic necrosis became result of thrombosis,  purpose of drugs for dissolution of blood clots is shown. At an inflammation of a wall of arteries antiinflammatory drugs are shown.
At damage  of a hip, knees, anklebones for simplification of a state use of crutches is shown to the patient.
Though these nonsurgical methods of treatment can slow down progressing of a necrosis, most of people with this disease finally will need surgical intervention.
Options of surgical treatment include:
1. Bone transplants which are a part of a healthy bone. Such bone transplants are used for replacement of the injured bones.
2. An osteotomy - the procedure which is applied to unloading of bones or joints.
3. Prosthetics of a joint - the procedure which includes removal of the injured joint and replacement with its artificial.
4. A decompression - the procedure which includes removal of a part of an internal surface of a bone to reduce pressure that will provide improvement of vascularization.
5. Use of a vaskulyarizirovanny bone transplant for which use own tissues of the patient for recovery of the injured hip joints.

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