AVN Of HIP and Complete Collapse Of Femoral Head

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Hi, I'm Ravi Shankar, 20, from India. 3 years ago, due to an accidental hip fracture, i had to go for a surgery, which involved fixing the femoral head (the ball part of the Ball-Socket Joint) to the femur(the rest of the lengthy bone part) with the help of 3 screws. Right now i'm suffering with severe AVN (Avascular Necrosis) and this resulted to a complete femoral head collapse. Doctors are saying that Hip Resurfacing is OUT of question and they MUST go for Cementless hip replacement Operation.

Now, the problem is that i'm doing my 2nd year engineering course and cannot afford to go for a replacement surgery at this age(20), which definitely fails working in around 6-9 years, and after that revision surgery has a less success rate.

Can anybody, (especially any surgeon) tell me to what extent can i go for this decision of a replacement surgery and to what extent does the ALTERNATIVE THERAPIES like ayurveda, reiki help to rehabilate back my hip to its normal state? Kindly reply to this question as soon as possible and please do not forget that my age is ONLY 20.

Thank you, ravi shankar

-- Ravi Shankar (kvss_ravi@rediffmail.com), May 20, 2004


Unfortunately, once the femoral head has collapsed there are not any surgical options other than replacement.

You can hold off on surgery for as long as you are able. Physical therapy to maintain as much range of motion in your hip would be important in the interim.

-- Mesfin Lemma, M.D. (mlemma2@jhmi.edu), May 24, 2004.

Dear Ravishankar, I am one of few surgeons who does hip resurfacing.I dont know who told that you can't have resurfacing. I would like to see your x ray to give a definite answer.

-- Dr.G.Balasubramanian (ggbala@hotmail.com), June 01, 2004.

Hi, I could not help but reply after seeing your question. In the Uk we do both Resurfacing as well as THR in patients younger than 30 Yrs.If your femoral head has collapsed to an extend that resurfacing is not possible then it is not an option. u would have to show the xrays to your surgeon to make that decision. we have been doing resurfacings in the UK for the past 10 yrs. we still do not have any real long term follow up results and iI still warn my patients that resurfacing though promising is not a proven techinique.Also if the femoral head is affected to an extend that resurfacing would be possible, if there are dead or avscular areas of bone under the implat then you are at arisk of the implant subsiding, haqving a femoral neck fracture or at the very least continue to have pain.so resurfacing may not be answer to all your problems nad needs to be considered carefully. Total hip replacement can give very good results even in young people.You should ideally have an uncemented hip joint witth ceramic bearing surfaces. I tend to use the JRI Furlong implant and have had good results with patients as young as 25 for over 15 years.Yes the life of any impant is finite but in 10-15 yrs things would have advanced , that there may be answers as far as revision goes. Also try and postpone surgery as long as possible, provided that thre is no continued colla[e of the head.I wish u all the best.

-- A.Pillai. MS MRCS FRCS (Aorthopod@aol.com), September 04, 2004.

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