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From a Prolotherapy doctor’s standpoint in working with patients in varying degrees of osteoarthritis, nothing sounds more terminal and ominous than another doctor telling a patient that their bone is dying, they have necrosis – death of bone cells.
Avascular necrosis Treatment
Probably no other diagnosis leads to a quicker joint replacement than “bone death.”
Bone death, medically – avascular necrosis (AVN), osteonecrosis, aseptic necrosis, or ischemic bone necrosis – develops in many ways. Ironically, corticosteroids, a treatment designed to assist in managing chronic joint pain is a leading culprit. Many researchers have speculated that possibly one-third of non-traumatic AVN is caused by corticosteroids abuse. Worse, it may not take many cortisone shots to begin the destructive process. If co-risk factors exist, the dangers are that much greater.
“Case reports of rare and infrequent use of corticosteroids and the development of osteonecrosis are of great concern to physicians, but most patients affected may also be at risk of developing osteonecrosis because of repetitive systemic corticosteroid use with underlying hyperlipidemia, alcoholism, smoking, connective tissue disorders, and/or previous trauma to the affected area — eventually surgical intervention is warranted in the treatment of osteonecrosis.”1
The non-surgical treatment of avascular necrosis
The standard treatments for AVN seemingly lead to a singular destiny – joint replacement. But are there realistic options? Case studies started to appear in the medical literature that explores Platelet Rich Plasma (PRP) and Stem Cell Therapy as possible solutions to bone death.
In one case PRP was found incredibly effective for advanced-stage degenerative AVN of the hip, with the patient demonstrating significant functional improvements and the ultimate outcome of being able to avoid surgery.2
The diagnosis of avascular necrosis should not mean automatic joint replacement, nor should its diagnosis need to be a “life-altering situation” in many cases it can be managed with the comprehensive approach of dextrose Prolotherapy, Platelet Rich Plasma, and Stem Cell Therapy.
1. Weldon D. The effects of corticosteroids on bone: osteonecrosis (avascular necrosis of the bone). Ann Allergy Asthma Immunol. 2009 Aug;103(2):91-7; quiz 97-100, 133. doi: 10.1016/S1081-1206(10)60159-7.
2. Ibrahim V, Dowling H. Platelet-rich plasma as a nonsurgical treatment option for osteonecrosis. PM R. 2012 Dec;4(12):1015-9. doi: 10.1016/j.pmrj.2012.07.009.