Progression and Treatment options questions : LUSENET : About Joints : One Thread

I have been diagnised with stage 2 ON in the Right hip and Stage 1 in the left hip. My Dr said being active would not speed the progression of the disease but my research on the net says that reduced weight bearing through the use of crutches may help delay the need for surgery, or perhaps prevent further progression while one weighs the treament options. Is there any research indicating this?

My Pain began 2 months ago and it has been almost a week since I was notified of the diagnosis. The Drs want to schedule me for immediate core decompression surgery on both hips. While it looks like surgery is very well indicated, I would like to buy at least 2-3 weeks to make a decision, especially as to how well concieved an idea it is to do both hips at once as suggested. Is it likely in that time my disease could progress to stage 3 thus complicating my potential for recovery? Can anyone tell me the averages for disease progression in time for someone at age 40 with non of the known stress factors as cause (with the possible exception of smoking).

Finally, is core surgery generally the best method of putting off THR or are there other non surgical treatments I could try to put off surgery as long as possible. Will using crutches help buy me some time to make an informed decision? Should I be tested every week to monitor progression?

Thanks in advance for any guidance and information. I would like a second opinion at the very least from a center that specializes in ON. Is Johns Hopkins the best? I have also Heard Hershey Medical center. I am relatively conveniently located to either, being Near Philadelphia, PA

-- Rhonda Morgenstern (, April 15, 2002


Rhonda, I was just diagnosed with bilateral avn of hips--I am in between stage 1 & 2 with both hips and used crutches prior to my first recent surgery. The premise is to keep the weight off of the hips to prevent further damage. I can advise that what I reserched showed that you should have some type of surgical intervention at the early stages in hope to delay total hip replacement. I am 49 yrs old and just had core decompression of rt hip but it is too early to advise if it has been successful. Good luck and hope that my note helps

-- LInda (LINDA_TYROLER@GLMSHOWS.COM), April 19, 2002.

I could be wrong, but I was told by my DR. that core decompressions was not a cure, it's just to help alliviate pain. Study it a litte more. The success rates arent even that good. But I might be totally wrong

-- kristin (, December 04, 2003.

After many years of pain, I was diagnosed with AVN of the left hip and had a total hip replacement in 1997. When pain started in the right hip in 2001, my Dr. prescribed an MRI, and based on those results (late Stage 2, early Stage 3) recommended core decompression. It is my understanding that ultimately, the core decompression only buys time. My pain has returned, and I anticipate a THR of the right hip within the next year or so, but the core decompression did buy me about 3 years.

Johns Hopkins (where I go) has much experience with what they call minimally invasive THR, which permits a speedier recovery. Dr. Simon Mears is a good Dr. to see at JH. Appointment telephone is (410) 550- 0101.

-- Bill Cooper (, March 23, 2004.

Rhonda: My ON was caused by a stress fracture too long ignored and which resulted in complete hip fracture...which my now ex-husband prevented treatment of for 3 days. By that time the damage was done. Since the fracture itself has been repaired, the ON has progressed significantly. Still, because of my age, my doctor here on the west coast recommended waiting for a hip replacement, which he feels the only course of action. It hasn't spread to any other bones, but it has *really* effected my quality of life. Although a relatively young woman, I use a cane always, a walker when the pain becomes unbearable, and pain meds almost continually. I wish you luck, Andrea

-- Andrea Johnston (, May 03, 2004.

How I can feel for everyone that has AVN. I have AVN in both hips,plus 17 surgeries since 1984. I had the left knee cap amputated and RSD{nerve pain}set in on the left knee and it has not been pretty. This old military vet had one to many jumps and had a case of bad luck one of those days when everything went wrong. Not like the movies. However at 51 yrs old I do not intend to give up and lock myself in the house which in tthe beginning I found myself doing. I loss my self confidence and the pain became overwhelming, to the point you just wanted to curl up and cry.Yes the swagger is gone and now replaced by crutches or my loyal cane. I live in the country and about 200 miles south west of Chicago,illinois. My question is, where can you go to receive the approiate medications for this 24 hr pain and as well as nerve pain from the reflex sympathetic dystrophy and the avascular necrosis. Plus two surgeries on the neck,c-6 c-7, that only partially worked. I will never be pain free but I would to be able not have the pain controll everything I do. Granted real estate is not a physical demanding occupation but I hate having tears running down my eyes when I get up to meet clients. This was a huge change for me, especially after being special forces for all those years and now I all I can do is sit behind a desk. However with this unholy pain that affects you mentally and physically their has to be some place you can go to receive the proper pain meds and not have to get down on your knees and beg for a pain pill. Sometimes I feel that having to practically beg for pain medication is as worse as the injuries. What would the proper medication be for these type of injuries. Thankyou for listening, David

-- David Fraser (, May 27, 2004.

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