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315-B, 3rd Floor Office, Unitech Arcadia, South City 2, Sector 49, (Near Good Earth City Center), Gurgaon. Office: 0124-4360590 Mob: 8447918981 ( In case of Emergency, pl SMS on 9718112112 ) ****************************************

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Medical Treatment for Avascular Necrosis AVN Hip

hip avn treatmentPersistent pain around the hip joint for more than 3-4 weeks, should always alert the treating Orthopedic for a possibility of Avascular Necrosis of Hip.

AVN or Avascular Necrosis as the name suggests, develops due to permanent impairment to the blood flow of Femoral Neck region. It is commonly seen in patients who have been treated with Steroids (Oral/ Injectible or Inhalational as in Bronchial Asthma) over a period exceeding 3-6 months. 

AVN Hip is defined as the irreversible changes in the femoral head, as a result of the interruption to the blood supply. It commonly follows fracture of femoral neck/ prolonged steroid intake/ alcoholism/ muco-polysaccharidoses/ sicle cell anemia etc.

The femoral head gradually undergoes changes in the density and architecture, ultimately leading to degenerative arthritis of hip joint. In late stages, when arthritis has already set in, the only effective treatment is a total joint arthroplasty.

However, in the early pre-collapse stages, there is some role for a group of drugs known as Bisphosphonates. Alendronate is a commonly used drug of this group. these drugs are available in both tablet and injection form; and dosing schedule varies from once daily to once a year.

Numerous studies have advocated that bisphosphonates, when used in early AVN hip (Ficat & Arlet stage I/II), results in improvement of symptoms and prevents radiological worsening in atleast 60-70 percent of patients. However, this drug needs to be taken for a period of 18-24 months to show appreciable improvement.

For stages II a/ II b, when the head has not collapsed, we recommend Core Decompression procedure to relieve the Intra-osseous pressure. This helps is maintaining blood supply in a significant number of patients who do not respond to conservative trial.

Take Home Message:

1. Any Hip pain persisting for more than 4-6 weeks  should always be evaluated by an Orthopedic specialist, and an X Ray may be advised if indicated.

2. Early cases of Hip AVN can not be picked on X Ray; so in cases of strong suspicion or patients not responding to conservative treatment, an MRI of Pelvis must be advised.

Not All Disc Prolapse Patients Need Surgery

spine surgeryDisc Prolapse technically means extrusion of the disc material that is lying between the vertebral bodies, into the spinal canal housing spinal cord and nerve fibers.

There are various grades of Disc Prolaspe - Annulus Tear, Disc Bulge, Dis Protrusion & Disc Extrusion.

Annulus tear leads to acute severe pain in lower back, often without leg pain. Subsequent attacks lead to leakage of nucleus…

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I feel Numbness and Pain in My Hand- Could it be due to Carpal Tunnel Syndrome

Wrist pain in computer operatorIndividuals who work on computer keyboards or use machine tools with lots of vibration or even those who need to write a lot; often complain of Pain, Burning or Numbness in Hands. These symptoms are often bad enough to even wake them from sleep.

Before we talk about carpal tunnel syndrome, we must understand that there are two or three common reasons why pain and numbness may come together in the…

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How We cure a Frozen Shoulder in Less than 3 weeks without Surgery

Frozen Shoulder is one of the most nagging problems that interfere with daily activities of our patients. Most of the patients are in 35-50 year age group.

Typically, patients complain of Shoulder pain persisting for 4-6 weeks, and then stiffness ensues. Gradually, the stiffness becomes predominant, and cause difficulty in day to day activities of personal hygiene and wearing clothes. It is…

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Suffering with Low Backache ? Is it a Disc Prolapse ?

Backache Treatment

Backache is a common complaint both among the young and fit individuals; as well the elderly population. Most cases of back pain are reported after a jerk or lifting heavy objects. Some cases are reported first after getting up in the morning. a small subset of patients do not relate any incident, but they do remember some discomfort in lower back while working in office.

Most of the back p…

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Reasons why you have Recurrent Shoulder Pain

shoulder painA common reason for pain around the Shoulder joint is Rotator Cuff Tendinits and Impingement syndrome.

Shoulder impingement syndrome causes limitation of shoulder movements in one or more directions, but never complete global loss of movements.

Also known as a "Painful arc syndrome"; when the arm is taken overhead in the window cleaning position, patient catches pain. Pain is reproduced on…

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Why It is Important NOT to Ignore your Knee Pain

knee pain treatment

In our clinic, 40% of patients visit us with Knee pain.

There are many reasons why you may develop a knee pain. Common causes include wear and tear of the cartilage that occurs as a result of aging or previous injury. Sometime, there could be a genetic component leading to arthritis in families.

While doing assessment of a knee pain, initial evaluation by an expert is the key to correct …

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Knee Pain in Young Boys & Girls who are active in Sports

Knee pain in childrenChildren who are active in Sports or Athletics often complain of Pain & swelling around the knee joints. Such pains tend to worsen with activity and settle down after rest for a week or so.

We know that bones in children develop from multiple centers of ossification. Some of these are called Epiphysis, while others are called Apophysis. Although, bones in children are very flexible, still somet…

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Reasons why you could be suffering with Knee Pain

knee pain during exerciseKnee pain is such a common complaint in our Orthopedic practice, that I decided to write something about it; so the readers may benefit by getting an insight into the medical intricacy of diagnosis and treatment planning.

Lets diversify our subjects according to Age. I 'll be focusing on common ailments which cause knee discomfort.

Adults, both Men & Women, between the age group of 25-35 yea…

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