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Why do I still have pain after operation for avascular necrosis?

Thursday, 15 May 2003
Answered by: Mathew Varghese
Consultant Orthopaedic Surgeon and Director
St. Stephens Hospital
Delhi
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Q. I have avascular necrosis of the hips. I have got an operation performed called core decompression. But I still have pain in my thighs, kindly advise what I should do?

A.  Core decompression is an operation that is commonly recommended for patients who are in the early stages of avascular necrosis of femoral head. In advanced stages this operation is ineffective. The operation is most successful in those patients who have pain in the hip at rest or pain which is worse at night. Patients who have pain on standing or walking do not do as well. Some patients are not benefited at all. The exact reason for this is not clear. You could be in any of the above categories. At this point of time all that I can say is you are a candidate who has not responded to core decompression. If your pain is persistent, which is quite possible in avascular necrosis you may need total hip replacement. The suitability of the operation in your case will have to be assessed by an orthopaedic surgeon.

A.  Core decompression is an operation that is commonly recommended for patients who are in the early stages of avascular necrosis of femoral head. In advanced stages this operation is ineffective. The operation is most successful in those patients who have pain in the hip at rest or pain which is worse at night. Patients who have pain on standing or walking do not do as well. Some patients are not benefited at all. The exact reason for this is not clear. You could be in any of the above categories. At this point of time all that I can say is you are a candidate who has not responded to core decompression. If your pain is persistent, which is quite possible in avascular necrosis you may need total hip replacement. The suitability of the operation in your case will have to be assessed by an orthopaedic surgeon.

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