Bilateral Hip Avascular Necrosis Concerns (15M)
Hello everyone, I am a 15-year-old who has recently completed a course of chemotherapy for lymphoma. Unfortunately, due to the steroids I was prescribed, I’ve developed bilateral avascular necrosis, with my right hip at stage 3 and my left hip at stage 2. I am seeking guidance on my situation, particularly since I am quite young and a total hip replacement (THR) seems unlikely at this stage. A few months ago, I experienced significant pain in my hips, but that is no longer the case. Currently, my discomfort is minimal, and I mostly feel some weakness instead. The orthopedic specialist I consulted suggested performing core decompression on the left side and possibly an osteotomy on the right, contingent on its viability. I would like to know if these recommendations are appropriate and if there are alternative treatment options I should consider. Additionally, I am curious about the expected recovery period, success rates of these procedures, and how my overall hip functionality might be affected moving forward. I appreciate any insights or advice you can provide. Thank you!
Answers (1)
8/31/2025, 10:41:51 AM
OpenHealth AI
It sounds like you're navigating a challenging situation with bilateral avascular necrosis (AVN) following your chemotherapy treatment. Given your age and the current status of your hips, it’s essential to explore your treatment options carefully to maintain the best possible quality of life for your condition.
Main Points:
- Current Recommendations: Core decompression and possibly an osteotomy are common treatment options for AVN, especially for your stages of degeneration.
- Alternatives: There are several alternative or supportive treatment methods to consider.
- Recovery and Functionality: Understanding what to expect regarding recovery time and how these procedures might impact your hip function is crucial.
Explanation:
Avascular necrosis occurs when there is a loss of blood supply to the bone, leading to bone death and potential collapse. The pain you previously experienced may have subsided due to the body adapting or the AVN not progressing further at this time. The recommendations from your orthopedic specialist of core decompression (which relieves pressure in the bone to help healing) and osteotomy (which involves reshaping the bone to redistribute weight) are indeed appropriate treatments for your situation.
Next Steps:
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Proceed with Core Decompression: This is typically less invasive and can improve symptoms and hip function. It has a reasonable success rate, especially in earlier stages of AVN. Discuss your orthopedic specialist's plan for this procedure in detail, including what to expect and potential risks.
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Consider Physical Therapy: Engaging in a tailored physical therapy plan can help maintain muscle strength and joint function, especially as you recover from procedures and adapt to changes in your hips.
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Discuss Osteotomy Further: If your right hip’s condition is viable for osteotomy, discuss the potential benefits and risks. This procedure can help improve alignment and reduce pain but consider the longer recovery and rehabilitation process.
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Monitor Symptoms: Keep track of any changes in discomfort or functionality of your hips. Noting any new symptoms can be essential for follow-up discussions with your orthopedic specialist.
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Lifestyle Adjustments: Focus on maintaining a healthy weight and avoiding activities that put excessive stress on your hips to mitigate further damage.
Regarding recovery, it varies by person and procedure, but generally, after core decompression, patients may require crutches for several weeks, with gradual return to normal activities over a few months. For osteotomy, the timeline can be longer, potentially up to 6 months before returning to full activities.
Always feel free to reach out for further clarification or to discuss your specific situation. It's great that you're taking an active role in your health!
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