Avascular Necrosis (Osteonecrosis) Treatment with Hyperbaric Oxygen Therapy
Necrosis means death of cells in a living tissue. That means, death of a tissue. Avascular necrosis – death of bone tissue due to loss of blood supply. As you may be aware, tissue is composed of cells and there are different types of tissues including muscle tissue, ligaments etc.
In the human body, bones and joints are surrounded with tissues. These tissues have blood vessels and as a routine, the cells in these tissues die and new ones are made. If the blood supply is stopped for any reason, the regeneration of cells stops leading to the death of the tissue. When the tissue surrounding a bone or a joint dies, the bone also eventually loses strength, cracks and crumbles. If this happens at the joint, the joint will not work as usual and treatment will be necessary and in some cases, the joint needs to be replaced.
Image Credit – Image by jcomp on freepik
Parts of the body frequently affected due to avascular necrosis:
- Hip joint – this pain may spread till the thighs, groin and buttock
- Knee joint – difficulty walking, standing, stair climbing. In short, every activity that puts pressure or weight on knees becomes difficult to perform.
- Shoulder – affects regular movement and lifting stuff.
So, what causes the blood supply to the tissues to stop?
Reasons for stoppage of blood supply to tissues is broadly classified into two:
- Traumatic
- Non Traumatic
Traumatic injuries are caused due to an accident where the bones and joints break, dislocates. Non traumatic injuries can be due to a surgery or any other medical condition that stops blood flow to the tissues. Certain medical conditions that can stop the blood flow to tissues are:
- Sickle Cell Anemia – Red blood cells are the ones that supply blood in the body. These are round in shape and flow through the blood. In some people, their shape changes to that of a sickle (or like a crescent moon) and doesn’t flow well. This results in lower oxygen supply of blood to tissues and other parts of the body. This is actually a bigger problem than just necrosis but sickle cell anemia can cause necrosis of tissues in the body.
- Decompression sickness – We discussed this condition in detail earlier. When the outside pressure rapidly decreases, gas bubbles start forming in the body leading to joint pain and neurological problems.
- Lupus – an autoimmune condition
- HIV – we need no introduction to HIV
- Chemotherapy for Cancer (weakens many parts of the body including blood vessels, tissues, heart etc)
- Usage of corticosteroids on a long-term basis.
Avascular Necrosis – Treatment options
In the very early stages, application of cold or heat pack or physical therapy or anti inflammatory steroids can be helpful. But after a certain stage, surgery may be the only option.
Surgical treatment options for avascular necrosis include:
- Bone drafting – In this procedure, the dead bone tissue is removed and replaced with healthy one from a different part of the body. As long as the blood vessels that supply blood to this area body are not damaged, this procedure will help.
- Decompression – Similar to acupuncture (not exactly), holes are drilled into the affected tissue. Due to the natural process of the body, blood will be pumped into the area to heal, as a result the tissue is also healed.
- Joint replacement with artificial joints – As a last resort, the joint is replaced. It’s a painful process until complete recovery but once the tissue is totally dead along with surrounding blood supplying vessels, this would be the only options doctors may be left with.
One other emerging treatment option for avascular necrosis – Hyperbaric Oxygen Therapy
Hyperbaric Oxygen Therapy, HBOT – breathing nearly pure medical grade oxygen under pressure. This results in more oxygen dissolving in blood and more oxygen getting supplied to every inch of the body for the duration of the therapy.
Consequently, damaged muscles, tissues, and blood vessels heal!
Now, apply this to the avascular necrosis condition. The increased oxygen supply helps in healing the damaged tissue around the bone. This also helps in regeneration of damaged blood vessels (if any) and also the bone tissue will get stronger, reducing the effect on the bone. Effect may not be seen in one or two sessions but may take a dozen easily to see the difference. The total number of sessions will be determined by your specialist. Isn’t it a no brainer to try HBOT before undergoing the knife? If your necrosis issue is detected early enough, HBOT can be a very helpful non-invasive solution to heal not just the affected area but your entire body including your brain tissue.
