Hip Bone or Joint Injury
Avascular Necrosis Hip
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Avascular Necrosis of Hip Treatment
Avascular necrosis of the hip can be treated with medication, physical therapy and surgery. Different stages of this condition will need different treatments, and the health and physical conditioning of the individual will also affect treatment choice.
Medications for Avascular Necrosis of the Hip
- Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, Advil, or naproxen, can reduce pain. If necessary stronger options may be offered on prescription from your doctor.
- Osteoporosis drugs can sometimes be used with the aim of slowing down the disease.
- Cholesterol-lowering drugs lower blood levels of cholesterol and fat can reduce the risk of blockages in the blood vessels that can lead to avascular necrosis.
- Medications that open blood vessels aim to improve the circulation reaching the bone.
- Blood thinners reduce the risk of blood clots in the vessels feeding the bone, which can lead to avascular necrosis.
Avascular Necrosis of Hip Surgery
For the majority of cases, around 80%, avascular necrosis hip treatment will be with surgery. Surgery is most often a total hip replacement, as this provides the most reliable positive outcome. But there other surgical options that can be considered. Core decompression can be used in less severe cases. Bone graft, osteotomy, and regenerative medicine treatment are also options, but more research is needed to understand their efficacy and which patient can benefit most from which procedure.
Avascular necrosis hip surgery recovery time is about 6 weeks for most people to be walking. For some, they will need the aid of a walking stick. It is recommended to continue rehabilitation for a further 6 weeks to fully regain strength and flexibility, and some people might need longer. It will usually take around 3-4 months to walk following a core decompression surgery as the first 6 weeks after this surgery are usually needed to be non-weight-bearing. These recovery times depend on several factors, including the specific surgical procedure carried out, as well as the individual’s health and physical conditioning.
Physical Therapy for Avascular Necrosis of the Hip
Physical therapy for avascular necrosis of hip treatment can help with pain management and relief, joint mobility and strength. Physical therapy, can be a helpful treatment for avascular necrosis of the hip, without surgery in the early stages of this condition. It is often also advised to aid preparation for surgery and rehabilitation after surgery for more advanced cases. Strengthening exercises can help with the stability of the joint and the efficiency of movement, which can improve walking gait.
Exercises for Avascular Necrosis of the Hip
The best exercises for avascular necrosis include strengthening exercises and mobility exercises for the hip joint. A strengthening programme should include exercises for the glute, hamstring, adductor and hip flexor muscles. Core exercises can also help with stability at the hip and pelvis and are useful to include. A strengthening exercise programme should be done two to three times per week.
Hip Abduction
Lie on your side with a resistance band tied around your ankles. Roll forwards so that your upper buttock is on top. Keeping your upper leg straight, start from inline with your body and take your leg up and backwards. This movement should come from your hip joint, not your back, so you should feel the muscles of your buttocks working, these are your gluteal muscles.
Perform 12-15 repetitions for 3 sets, with a 1-2 minute break between.
Glute Bridge
Lie on your back with a resistance band tied around your thighs, just above your knees. Your feet should be hip-width apart, and your knees should be bent to about 90º or slightly less so that your feet are not too close. Lift your pelvis up while keeping outward pressure on the band. You should feel the muscle of your buttocks and the back of your thighs working. If you don’t feel the back of your thighs working, your feet should be further away.
Perform 12-15 repetitions for 3 sets, with a 1-2 minute break between.
Hip Adduction
Stand with a resistance band tied around one ankle and something sturdy to your side. Maintain balance on one leg and start with your other leg out to the side, pull the band inwards towards you. You should feel the muscle along the inside of your thigh working, these are your adductors.
Perform 12-15 repetitions for 3 sets, with a 1-2 minute break between.
Hip Flexion
Stand with a resistance band tied around one foot/ankle and stand with your other foot on the other end of the band. Maintain balance on one leg and a straight upper body posture. Raise the other leg against the resistance band, with a bent knee up until your reach a 90º angle at your hip. You should feel the muscle at the front of your hip working, these are your hip flexors.
Perform 12-15 repetitions for 3 sets, with a 1-2 minute break between.
Core Strengthening
Lie on your back with knees bend and feet on the floor. Flatten your back against the floor using your abdominal muscles, and raise your arms towards the ceiling. Raise one foot off the floor at a time into a tabletop position (right leg in the picture) keeping your back flat against the floor and abdominal muscles engaged and flat. If you can keep your tummy flat in this position you can straighten one leg away then return and repeat on the opposite side.
Perform 6-8 repetitions on each side for 3 sets, with a 1-2 minute break between.
Physiotherapy with James McCormack
This is not medical advice. We recommend a consultation with a medical professional such as James McCormack. He offers Online Physiotherapy Appointments.