Osteonecrosis means “bone death”. Loss of blood supply, bone death, and collapse can occur over a period of months to years. The femoral head is the round ball at the top of the thighbone that fits into the hip socket. Osteonecrosis can be caused by steroid use, alcohol, trauma, and blood-clotting problems like Sickle Cell Disease. In some cases, no cause can be found. Many people who have been diagnosed with osteonecrosis of the femoral head already have the same problem in the other hip. They just don’t know it because the disease can be “silent” or asymptomatic. In other words, there’s no pain. If it wasn’t for the telltale signs on X-ray, the affected individual wouldn’t even know there was a problem.The majority of people who have femoral osteonecrosis in one hip will go on to develop the same problem in the other hip. But this isn’t always the case and even if it does happen, treatment may not be needed.So how does a person decide what to do? The first goal in treating symptomatic (painful, limiting) osteonecrosis of the femoral head is to save the bone. The second goal is to keep function while relieving pain. Your surgeon will be able to advise you as to the best course of action for you. That still doesn’t answer the question about what to do for that asymptomatic hip. Is treatment needed at all? What’s the natural history (i.e., what happens over time if it is NOT treated)? In a recent systematic review of the literature, surgeons who conducted the study concluded that large lesions along the outer two-thirds of the femoral head are in the greatest danger of further destruction and collapse. Those should be treated right away. Small-to-medium lesions can be watched carefully and treated conservatively at first. Any sign of progression of disease should be addressed immediately. Anyone with known risk factors (Sickle cell disease, prolonged use of steroids, alcohol abuse) should be watched closely as well.

For more information on this subject, call The Zehr Center for Orthopaedics at 239-596-0100 or visit www.zehrcenter.com. The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of a visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.

You didn’t say your mother’s age but age may be a factor. Older women are at increased risk for this problem. There’s an increased number of these fractures in women who are postmenopausal. Osteoporosis (decreased bone density) in this age group is another important factor.

Without its normal resiliency, the simplest, everyday stress can cause damage to the bone. Anyone who has arthritis is also at increased risk. Often, the osteoporosis added to any slight knee deformity can be enough to cause this problem.

Other factors include alcohol use, Crohn’s (intestinal) disease, and the use of steroids for arthritis. Low calcium absorption, vitamin D deficiency, and hormonal changes are also factors.

For more information on this subject, call The Zehr Center for Orthopaedics at 239-596-0100 or visit www.zehrcenter.com. The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of a visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.

There aren’t too many studies just on the duration of pain relief with steroid injections into the joints. Results range from one week as in your case up to 13 weeks.

It’s clear that steroid injections work better than placebo injections with saline solution. And studies show that some steroids work better than others. Long-term pain relief may require a higher dose of the steroid.

In some cases steroid injections are used to control pain and reduce rehab time after arthroscopic surgery. In a patient with recurring bursitis there may be other factors such as posture and overuse to be addressed. The injection may help calm the joint enough to work on improving alignment and motion. Combining physical therapy with steroid injection may be one way to improve overall results.

For more information on this subject, call The Zehr Center for Orthopaedics at 239-596-0100 or visit www.zehrcenter.com.The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.