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what is the ideal treatment of grade 2 and grade 3 Avascular Necrosis of hip joint involved bilaterally?

Posted by saurabh

my uncle has Myesthenis gravis since 20 years.

he was on prednisolone 40mg/day for about 1 year

at present ae is on Pyridostigmine and Azathioprine

he is suffering from grade 2 Avascular Necrosis of Right hip and Grade 3 AVN in left hip joint

his age is 47 years

what should he do for this? 

Answers (2)
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I was diagnosed with stage 3 AVN in my left hip a year and a half ago. Doctors kept holding off treatment because they didn't know what 2 do about it and theres not alot of doctors around that knows anything about it. well yesterday i went to a local hospital that found me a doctor 2 hours away that could help. Turns out i have it in both hips and the doctor told me both legs are on the verge of collapse and i'll have to get hip replacements in a year. and i just turned 22. He told me that if i would have seen him months before that he could have probably treated me with core decompression or bone grafting, now since all the doctors i tried to get to help me, took so long. Its just a slow painful waiting game to see when I can't take anymore pain. So if you have any kind of worrys i recommend you getting to a doctor ASAP and making sure they get you in for Xray and a pelvic MRI and really push the issue, because if you wait 2 long It might be to late
hey thank for your suggestion. i too was in a dilemma for the treatment options. you are having grade 3 avn but i dont know about the femoral head surface and that if there is also secondary osteoarthritis of hip joint associated or not. so its difficult to comment on your case for me. well i m a doctor by profession but not an ortho specialist so my knowledge is limited but i had inquired about bone grafting and decompression and i found that the results are not conclusive. that didnt encourage me to ask my uncle to go for that. then about 3 months back i went to an ortho surgeon with my uncle. he ordered x ray of both hip joints. he said that that avn is there but no associated osteoarthritis or joint collapse. so he put my uncle on bisphosphonates (residronate) and some pain killers and anti inflammatory tablets. presently my uncle is doing good with those medicines and is under follow up. he doesnt have to limp now and is better with is walk also. although he complaints of pain after exertion. i dont know how much you will be benefited by this information but i can say that if ur joint cavity is collapsed then you should go for hip replacement. yes i know u are too young for this but i tell you one thing that with better joint implants like ceramic on ceramic the life after replacemnet is much better and also that if you have to re operate after say 20-25 years , which is considered as the age of this ceramic on ceramic implants, its much easier and feasible to do that re operative replacement at a later stage of your life.
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