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    UHMS Indication #17

    Avascular Necrosis (Aseptic Osteonecrosis)

    Avascular necrosis occurs when bone dies due to loss of blood supply. HBOT may help preserve bone and delay or prevent joint replacement.

    What is Avascular Necrosis?

    Avascular necrosis (AVN), also called osteonecrosis, occurs when bone tissue dies due to interrupted blood supply. It most commonly affects the hip, but can occur in the knee, shoulder, and other joints.

    Risk factors include steroid use, excessive alcohol, trauma, certain medical conditions, and diving (decompression sickness). Once bone dies, it weakens and eventually collapses, leading to arthritis and joint destruction.

    Early-stage AVN may be amenable to HBOT, potentially delaying or preventing the need for joint replacement surgery.

    Symptoms

    If you or someone you know is experiencing these symptoms, seek medical attention. Early intervention is critical for many of these conditions.

    Warning Signs
    • Pain in affected joint, especially with weight bearing
    • Pain may be present at rest as disease progresses
    • Stiffness and limited range of motion
    • Limping (if hip or knee involved)
    • May be asymptomatic in early stages
    • Often discovered incidentally on MRI

    Orthopedic Treatment Options

    Treatment of AVN depends on the stage of disease and joint involved. Early intervention offers the best chance to preserve the joint.

    Activity Modification

    Reducing weight-bearing stress on the affected joint to slow progression.

    Core Decompression

    Surgical drilling to relieve pressure and stimulate blood vessel growth in early-stage disease.

    Bone Grafting

    Vascularized or non-vascularized bone grafts to provide structural support and blood supply.

    Joint Replacement

    Total hip or knee arthroplasty when joint collapse has occurred and pain is uncontrolled.

    How Hyperbaric Oxygen Therapy Helps

    HBOT stimulates the growth of new blood vessels into the ischemic bone, potentially restoring blood supply before irreversible damage occurs. It also reduces bone marrow edema and pain.

    The best outcomes are in early-stage disease before significant bone collapse. HBOT may be combined with core decompression surgery for optimal results.

    Key Benefits of HBOT for Avascular Necrosis

    Stimulates new blood vessel growth in bone
    Reduces bone marrow edema and pain
    May prevent disease progression
    Could delay or avoid joint replacement
    Enhances healing after surgical intervention

    Treatment Protocol

    Treatment is typically at 2.0-2.4 ATA for 90 minutes daily. A course of 30-40 treatments is common for AVN.

    MRI monitoring helps assess response to treatment. Early-stage disease (Ficat stage I-II) responds better than later stages.

    Ready to Explore HBOT?

    Schedule a consultation with our hyperbaric medicine specialists to discuss whether HBOT may be right for your condition.