Aseptic hip necrosis
Around 150,000 patients suffer from hip necrosis each year in the USA. The cause, if there was no accident, is not known but we know that the regular cortisone and alcohol are a contributing factor. men between 50 and 60 years are most often affected. Hip necrosis is a common cause of disability in relatively young and active people .
Bone destruction is due to a micro-circulation disorder. At first the patient complains of hip pain, thereafter, his mobility is reduced. The diagnosis should be made early by imaging. Other locations such as the knee are possible. If treatment is not started quickly, the hip prosthesis comes into question. Painful edema of the bone is a completely different situation. Here we are talking about a circulation disorder that would be responsible for the pain. The disease usually heals spontaneously after 6-8 months, hip necrosis can sometimes develop . In both diseases, hip pain is the first sign of disease. Depending on the statistics, knee necrosis occurs in between 3% for fifty-year-olds and 9% for 65-year-olds.
Goal of treatment
As hip necrosis and resistant bone edema mainly affects young people and this can end in bone destruction requiring the fitting of a prosthesis, early diagnosis is essential. HBOT can decrease or suppress pain. It also regenerates the affected bone and thus avoids the prosthesis. In the case of spinal edema, HBOT accelerates the healing process and allows the healing of refractory cases.
2010, a randomized double-blind study on 20 patients with unilateral incipient femoral head necrosis ( Ficat stage II im X-ray ) showed that the disintegration of the hip can be stopped with HBO. After 6 weeks of HBO the pain was significantly reduced, and the mobility of the hip joint was much better. In the MR, the bone loss after the treatment was significantly smaller. All patients were able to avoid the hip prosthesis and all had no new bone necrosis on the other side. These good results could be confirmed with MR controls after 1 and 7 years . Another study confirmed these results . Better healing of bone marrow edema . Good results have also been found in children and teenagers who have been treated with cortisone for leukemia. A more recent study shows a success rate of 98% 11 years after HBO therapy.
HBOT is said to be as good as surgical core decompression. The combination of HBOT and core decompression is said to be even better.
Similar successes have been found in the treatment of knee necrosis. The necrosis decreased significantly with HBOT whereas it remained unchanged with the conventional combination of weight relief and alendronate.
Practical use of HBOT
181/5000 At least 30 daily sessions are generally prescribed. HBOT should be used only in the early stages.