Aseptic necrosis of bones and joints
Stages of aseptic necrosis
There are several stages in the development of this pathology. At the first stage of the disease, the structure of the bone tissue is slightly changed, the hip joint retains its functions, and the pain is periodic. The second stage is associated with the formation of cracks on the surface of the head of the hip joint. Restrictions in mobility and constant pain are observed.
The third stage is secondary arthrosis, the acetabulum is involved in the pathological process. Joint mobility is significantly reduced. This stage is characterized by constant and severe pain. The destruction of the femoral head, constant pain, atrophy of the muscles of the thigh and buttocks, minimal mobility of the hip joint are signs that indicate the fourth, most severe stage of development of necrosis.
Aseptic bone necrosis
Aseptic necrosis is a serious disease caused by a violation of the structure of bone tissue, its nutrition and fatty degeneration of the bone marrow. There are many reasons for the death of a piece of bone tissue or of the entire bone. The development of aseptic bone necrosis can result from impaired blood circulation, traumatic injury, or arterial thrombosis.
Fractures, the use of unskilled medical manipulation, prolonged mechanical stress, diseases of the endocrine system, alcohol intoxication or large doses of corticosteroid drugs, osteochondropathy, Kummel's disease - can become prerequisites for the destruction of bone tissue.
Bone necrosis leads to irreversible changes, the strength of the bone tissue decreases, and with minimal stress on the affected area, an impression occurs. With a timely visit to the doctor, the process of pathological changes in the bone may stop, and then it is possible to restore its structure.
Aseptic necrosis of the femoral head
The femoral head refers to problem areas in which blockage of arteries often occurs, accumulative damage due to overload and domestic injuries, complex injuries of the hip joint (fracture of the femoral head). Various pathological processes can lead to aseptic necrosis of the femoral head.
This can be: toxic effects after taking hormones and cytostatics, antibiotics, alcohol abuse, stress, congenital dislocation of the hip (dysplasia), osteopenia and osteoporosis, systemic lupus erythematosus, ankylosing spondylitis, rheumatoid arthritis. Often on the list of causes are tolerable colds, inflammatory diseases, accompanied by a slowdown in blood circulation.
In most cases, the orthopedic prognosis is disappointing; severe deforming arthrosis of the hip joint is observed, in which endoprosthetics, arthrodesis of the joint, or corrective osteotomies are often used. Early diagnosis using magnetic resonance imaging (MRI) of the hip joint allows early detection of the onset of the disease and sometimes even conservative treatment gives excellent results, excluding surgery.
Aseptic necrosis of the hip and knee
The hip joint consists of the articular (acetabular) cavity and the femoral head. It is the largest spherical joint in humans. Its blood supply is carried out by a single artery that passes through the neck of the femur.
In the event of a violation of blood circulation, the blood supply to this zone is disrupted, the supply of oxygen and nutrients stops, and the properties of bone tissue deteriorate. Recovery processes become impossible, and a degenerative joint disease (osteoarthritis) occurs, accompanied by severe pain.
This further leads to aseptic necrosis of the hip joint. In this case, the replacement of the damaged joint with an artificial analogue (endoprosthetics) is shown, which contributes to the complete restoration of motor activity.
The appearance of destruction in the knee joint is preceded by injury and loss of blood supply, resulting in aseptic necrosis of the condyles of the bones that form the knee joint. This leads to loss of articulation and disability. Aseptic necrosis of the knee joint is manifested by pain and decreased mobility of the knee. Magnetic resonance imaging and bone scans show early changes in bone and help prevent further bone loss.
Nonsteroidal anti-inflammatory drugs (NSAIDs) reduce pain and inflammation. When surgical intervention is indicated, patients are assigned a bone graft in combination with decompression (weakening of pressure in the bone) or bone dissection, which is necessary in the progressive stage of aseptic necrosis. The most common method is joint replacement, i.e. replacement of a joint with an artificial joint.
Aseptic necrosis of the humerus and talus
The disease is manifested by pain in the area of the shoulder joint, limitation of movement, which later leads to atrophy. Changes in the structure of the humerus are rare. If the disease progresses, then they resort to surgical intervention - endoprosthetics, which is currently the only way to restore the lost function of the upper limb.
Mouche's disease is the name of the necrosis of the talus arising spontaneously and rapidly progressing. Degeneration of the ankle joint leads to deforming arthrosis. Modern diagnostic methods make it possible to detect changes in the ankle joint at an early stage. During this period of pathology development, mosaic osteochondroplasty of the talus block can be applied and the anatomy of the joint can be restored.
Article author: Mochalov Pavel Alexandrovich | d. m. n. therapist
Education: Moscow Medical Institute. IM Sechenov, specialty - "General Medicine" in 1991, in 1993 "Occupational Diseases", in 1996 "Therapy".
