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Asking for Other, Male, 55 years old, Abbottabad
Male, 55 Diagnosed with Avascular Necrosis of Femoral Head Left and with complaints of severe Pain in Left Hip and mild pain in Right Joint since 1.5 years. (see the attached MRI Report of 9/3/18) Decompression (joints drilling) already performed for both joints in March 2018. X. Ray report didn't show anything but last MRI performed at the end of October 2018 showing slightly better as previous MRI attached. The patient can't walk easily without the cane. Sometimes feel severe pain all the time and sometimes feel pain at night only while changing the position. Patient apparent condition seems to be at stage 2. Patient also face sleep apnea during medicine. The surgeon advised him total Hip Replacement Surgery which is not at all affordable for the patient. Is there any alternative like bone grafting to avoid replacement?
The ideal treatment is total hip replacement. If that can’t be done due to medical or financial issues then the focus is really on pain relief . In terms of medical management of the condition, bisphosphonates can be tried with variable results . So he can try bisphosphonates like Tab Bonviva 150 mg monthly , or Tab Adronil which will be cheaper than Bonviva.
Reviewed the limited information providedAt this moment he will need to find a place to perform his hip replacement (If can not afford private seek help fromGovernment) as if he is a candidate of total hip replacement and doesn’t do it in timely fashion it can lead to total collapse of the hip joint which then becomes a major major health issue.
it looks like decompression helped to improve the condition but unfortunately arthritis is also coming in.
there is an option of bone grafting but it's a lengthy surgery. with increasing age as your dad is, results are unpredictable. surgery will also cost you good money.
so i think, once pain is really bad for him, best way out is hip replacement which has very good success rate of 98-99%.
Member
M Farrukh
Dr Shakaib Qureshi, Genesis Healtcare Consultants,
96-Shadman Jail Road Lahore, he is best Rheumatologist in Lahore, 042-32591427, 82
Member
Faisal Rafiq
Dear Sir
I have pain in hip joint and under treatment. Using steriods delta cortil 5mg 3 tablets per day. I want to do MRI test with contrast in order to deduct AVN. Can I do that test while taking steriods?
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