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avascular necrosis
Started by anne
Posted: December 19, 2010 at 12:29
I have had a pain in my knee going up to my thigh since july, doc done mri nd exray, all clear, got worse by the week, after quite a lot of painkillersand acupuncture etc, still in pain getting worse, I said there must be something wrong, in between times I was flying backward and forward to London from jersey short flight but done 6, so he exrayed again and found my hip to have avascular necrosis, which had hppened in 3 months, he couldnt understand this, put on surgeons list for a hip replacement, in between waiting for a slot to have op, i started to cough upa small amount of blood was rushed into hos, dvt also Pulmory embolism in lung, my legs were scanned next day, found clot behind my knee, which I have had pain in since july, have I had this since then, is this why my hip died, please if you can help, im now on warfarin so cant have op, on morphine patches for pain, i feel like a walking timebomb thank you.

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Re: avascular necrosis
Reply #1 by Linda
Posted: December 19, 2010 at 12:56
Anne,
I did a Google search on "avascular necrosis". They mention "interruption of the blood supply" as being a cause for this to happen. They also mention "thrombosis". So, yes, the DVT most likely caused this. This is the first I have heard of avascular necrosis on this board. Hopefully someone else will have more information for you. I am so sorry that you are going through this.
Linda
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Re: avascular necrosis
Reply #2 by Tom in Connecticut
Posted: December 20, 2010 at 13:21
Here is some good information from the Mayo Clinic:

http://www.mayoclinic.com/health/avascular-necrosis/DS00650

As far as hip surgery, I am on Coumadin for life and had mine replaced in December of 2009 with no problems at all. I have had two separate DVTs and a PE (both back in the 90's) and also have Factor V Leiden clotting disorder.
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Re: avascular necrosis
Reply #3 by anne
Posted: December 21, 2010 at 12:55
Thank you so much for you replies, I have now developed 2 abcesses on my back teeth, have to keep an eye on my levels, they are just going to get the nerve out, hopefully this will go well,I just feel so lucky to be here, cant believe I have been walking around with this.for so many months. Take care hope you all have a good christmas.
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Re: avascular necrosis
Reply #4 by anne
Posted: December 21, 2010 at 18:58
Hi Tom, im glad your surgery went well, we live on a small island, so they have not seen this before, i said could it be to do with the dvt in the back of the knee, my doc does not think so, its been there since July, and Ive had this terrible pain since then, so to me it points to the dvt blocking the blood flow. im so frightened, they make me feel this is very tricky and they dont want to do op, to be in pain like this till next may, when the 6 months time frame for warfarin is up,I just dont know what to think, but ive lost all confidence. Thanks again.
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Re: avascular necrosis
Reply #5 by lexie
Posted: December 21, 2010 at 22:32
hi yes I lost my right head of femur from avascular necrosis at 28 I had to wait until I was 40 to have a total hip replacement. In the end I could only walk short distances with crutches. Have 7 clots in right leg. occluded common iliac vein and internal iliac vein. I was switched to clexane pre surgery and and ivc filter was inserted. Now 18 months post surgery I can walk and get around the pain in leg from clots is nothing compared to hip pre replacement. I still through clots regularly even on warfarin but it has given me a great quality of life. I have been told to enjoy living as my clotting disorder is out of control and unidentified by experts around the world. It will continue so I wear my compression stockings, take warfarin and clexane and get on with it. I have also been told that the other hip will most likely clot sometime in the next ten years. Merry xmas and I hope you know your not alone out there as scary as it can be sometimes.
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Re: avascular necrosis
Reply #6 by doris
Posted: February 4, 2011 at 09:26
hi all,

reading this comments from u all is so encouraging. I am a 30 year old sickle cell patient. I suffered AVN on my left when I was 17, was told that it is one of the complicains in sickle cell. I was on crutches for about 2 years after which i felt better(with pain once in awhile). However recently i was admitted in the hospital for DVT, was placed on both warfrin and clexane. Now I am out of the hospital and still on warfin till at least my INR is cerified ok.But the AVN pain is now so painful i can bearly walk. Now is DVT the cause of this pain or is the AVN the cause of the DVT? I would really like to know. secondly the compression stockings does it really help and how can i get 1. Finally with the stockings do i still have to go through a hip replacement? I am kind of scared of the operation.
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Re: avascular necrosis
Reply #7 by Anne
Posted: February 4, 2011 at 17:24
HiTom i have dvt and pe in lung need hip replacment, the hospital here does not have the facilities to do op with filter,but they said you will be ok, but the anethatist said dont have it here go to the mainland, where they can accomodate me better.I dont really want to go to the mainland or have a filter come to that, they seem to carry lots of side effects, but if I need one I would like to be in a hospital that has the facilities.I saw my doctor today and i feel he thinks im making a fuss. I see Tom you were advised to go ahead just with medication cover, to get of the island it would take a few hours dooor to door.any advice would be appreciated Anne
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Re: avascular necrosis
Reply #8 by Tom in Connecticut
Posted: February 4, 2011 at 17:49
Anne,

Originally the Orthopedic Surgeon desired the filter but I believe more so because he was against the use of anticoagulants. I did not have a filter installed, I personally feel, especially after speaking with several blood clot specialists who are friends of mine, that bridging with Lovenox and Coumadin was all I needed. Yes the temporary filter would have been an added precaution but I don't think it was necessarily needed nor did the hematologist who monitored my anticoagulation prophylaxis prior to and following surgery.

My surgery was done at Yale University Medical Center. On the floor were other patients who had knee and hip surgery; I was the only one who was on Coumadin (the rest were on aspirin which didn't protect from venous clots, only arterial clots).

Where are you located? Reason I ask is Rivaroxaban has been approved outside the U.S. for knee/hip replacement surgery. With Rivaroxaban you do not need to bridge. Just another consideration. Orthopedic Surgeon as a whole are against anticoagulants for fear of excess bleeding. There are those who believe in it but they are the minority. This is why hip and knee replacement is the leading cause of hospital acquired DVT (lack of proper prophylaxis).
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Re: avascular necrosis
Reply #9 by Tom in Connecticut
Posted: February 4, 2011 at 17:56
Anne,

I should have mentioned, in lieu of your experience with Coumadin, that Lovenox shots 14 days after surgery is a viable alternative. I do not know of any association with Rivaroxaban and Vascular Necrosis so that is another alternative. The reason I was on Coumadin was because I am on it for life.

Please keep me posted on what the doctors decide. After far as the hip surgery goes, it was a pretty easy recovery and I wish I would have done it sooner. They had me up and walking the hospital floor after the surgery that evening. By day two I was walking the fire escape. I'm not sure if they are doing minimally invasive surgery on you or not but if you have the choice, minimally invasive is a faster recovery time.

Best of luck and keep me posted.
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Re: avascular necrosis
Reply #10 by Anne
Posted: February 7, 2011 at 22:23
Hi Tom, sorry I have been having trouble posting on this site, I have repled to you, but dont know where the posts have gone, I live on a small island not far from France, called Jersey, Channel Islands, we have a small hospital here and also good surgeons. but the consultant anethetist has told me to my face and in a letter, I was a risk case, I have had Rheumatic fever when young and im also overweight, he said I should be in a hospital that has the filter as a stanby. we have no facilities or radiologist here on the Island to do this, and he definately wont do it, although we do have other doctors who will, so my doctor tells me. the vascular doctor and hemotoogist say it should be fine, and also they dont like filters, they dont seem to use them very much here in UK. I hope this gets to you, Hope you are feeling good. im on 8 1/2 mg of warfarin but today I have had some niggly pain in my chest. Thanks again Anne
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Re: avascular necrosis
Reply #11 by Anne
Posted: June 3, 2011 at 11:04
Hi, iposted on here a while ago, I have a AVN of the hip, I was waiting solong for Hip replacement that I ended up with DVT leg and small PE, I feel so weak what with just doing nothing for 7 months, have tried to do chairarobics but hasnt made much difference, im due next month 6thJuly to go for op, with a filter which im not really happy about after reading about them, because i feel so weak, im also worried about hospital bug, can anyone tell me if they have any tips somebody suggested probiotic drinks, Manuka hone, to keep the immune system in tact, and because I feel I have not much energy I would give them a go, can anyone tell me if they know of anything or any tips.Thanks
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Re: avascular necrosis
Reply #12 by ray
Posted: September 20, 2011 at 15:42
I have avn, had surgery on 8/23/11 where they drill into the femur and fill hole with bone from a cadaver. I have had a lot of strange pain. The pain was almost unbearable. I take coumadin already do to another lucky break endocardaitis about 6 years ago (mechanical heart valve). Has anyone had this surgery and can you tell me best and worst case scenario. What might my life be like if this is successful
Thanks
Ray
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Re: avascular necrosis
Reply #13 by ray
Posted: September 20, 2011 at 15:43
I have avn, had surgery on 8/23/11 where they drill into the femur and fill hole with bone from a cadaver. I have had a lot of strange pain. The pain was almost unbearable. I take coumadin already do to another lucky break endocardaitis about 6 years ago (mechanical heart valve). Has anyone had this surgery and can you tell me best and worst case scenario. What might my life be like if this is successful
Thanks
Ray
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Re: avascular necrosis
Reply #14 by hip resurfacing
Posted: February 11, 2012 at 06:15
there is something new for avascular necrosis called birmingham hip resurfacing and also called birmingham mid head resection both are very good therapeutic modalities when performed by a good surgeon with the prosthesis intact in 95%% of patients at 20 years,also wiht this you can do all activities you used to do before like running and jumping which you cant do with thr
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