AVN and hyperbaric trtmnt

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Any experience or insight into hyperbaric treatment for AVN? THX

-- bill britton (billbritton1@email.msn.com), October 01, 1999


Response to avn and hyperbaric trtmnt

HBO therapy is used for TMJ necrosis and for some of the head region necrosis that can result typically from radiation used in oncology to the head and neck regions.

It is currently not a viable alternative for the "typical" bone necrosis that occurs secondary to steroids, ETOH consumption etc. that type of necrosis (both secondary and spontaneous), typically remain hidden to the patient and the doctor for quite some time after the causative "event", until they are able to become decernable. The lesions are often extensive by that time, with little or no blood supply reaching the regions by the time they are caught. Thus, the use of HBO therapy has not been associatd with any success in restorative bone or function aspects.

HBO can however, and is, extremely useful in scuba medicine when a person has undergone "the bends" in a decompression accident. HBO therapy used immediately upon the inception of the "event" that can result in necrosis, is generlaly very successful in eliminating the occurrence of the possibility of resulting necrosis of the bone. however, it is not 100% in all cases effective. but the results are so good that it is now standard practice to get the "bent" person into an HBO chamber as immediately as possible. Unfortunately the chambers have not been helpful in reversing the type of osteonecrosis that is more typiclaly presented to the orthopedist far eveolved down the road into the "stages" of the disease process. other techniques from conservative weight bearing measurements, to things as dramatic as joint replacments are some of the more typical therapies that are necessary to correct the situation.

-- (Msmorro@aol.com), October 03, 1999.

I have come across a study from Israel that gave very promising results with HBO therapy and AVN in patients who had very early (stage 1) disease. There was an 81% remission rate after an extensive course of HBO. The problem is that the sample size was very small (12 and 16 patients). We really need to see this studied more extensively.

Since HBO is used successfully in the treatment of Radiation induced Osteonecrosis (and is usually covered by insurance for this indication), I think it would be well worth the trial of HBO treatments (although it's a huge time committment) to possibly avoid surgery in the case of very early AVN.

-- Marie Fetter (mariefetter@yahoo.com), August 31, 2003.

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