Young male cap bone necrosis

HanoiA 22-year-old man with pain on both sides of his hip joint, having difficulty walking, having to use crutches, his doctor discovered stage 4 femoral cap necrosis.

Doctor Duong Dinh Toan, Institute of Trauma and Orthopedics, Vietnam Duc Friendship Hospital, said that the patient has been receiving antidepressant drugs for 3 consecutive years, has stopped taking drugs, gaining weight. X-rays showed fracture lesions under the cap and total dissection of the right femoral tip. The left femoral tip is similarly damaged, with the prognosis of having to replace the left hip joint in a short time.

According to Doctor Toan, hip replacement in young patients affects the ability to work and daily life after surgery. Even for the rest of his life, patients have to deal with joint replacement operations due to limited lifespan of artificial joints. According to research, the joint replacement surgeries face more challenges and difficulties than the first one.

Film taken before and after hip replacement for the patient. Image: Hospital provided.

Femur capillary necrosis is caused by damage to the blood vessels that feed the femur in the femur. The reason for this is not clear, but it is often seen in divers, mine workers, people who use corticosteroids for a long time, people with smoking and alcohol habits. Perennial. The disease progressed silently, getting worse, eventually hurting, losing function of the hip joint, requiring joint replacement.

“For this patient, the current literature has not recorded an association between patients taking depressive drugs and femoral head. However, the appearance of the disease too early, rapid progression in the patient is still unexplained.” Dr. Toan said.

There are many methods of artificial hip replacement that are used in patients with osteonecrosis such as surface replacement, full hip replacement and good results. About 99% of patients feel pain free and walk almost normally.

Doctor examines the patient after hip replacement.  Photo: Hospital provided.

Doctor examines the patient after hip replacement. Image: Hospital provided.

Most of the cases before surgery due to pain, inactivity of legs for a long time, causing the thigh muscles, buttocks to shrink. So after surgery, especially in the first 8 weeks, the risk of artificial hip dislocation increases. After that, when the patient exercises well, the muscle becomes firm again, this risk will gradually decrease.

During exercise, the patient can walk on the newly replaced hip joint, but at first it will hurt and feel stiff. At that time, the surgeon will advise the patient to use supportive crutches when walking and with the right leg. Along with the exercise protocol given by the rehabilitation doctor, the patient will adapt gradually, the pain will gradually decrease, until the pain is gone.

Le Nga