For Koreans, who have traditionally led a sedentary life, the yangban-dari is a familiar and comfortable posture, unlike Westerners. Although it is gradually changing to a standing life environment, the habit of sitting cross-legged on the bare floor is still there.
Therefore, many people suffer from chronic musculoskeletal disorders because of their traditional lifestyle. In particular, if there is pain in the groin and buttocks, avascular necrosis of the femoral head may be suspected. There are situations when it is difficult to walk straight or cross legs.
Learn more regarding this type of avascular necrosis of the femoral head with Seungwoo Kang, an orthopedic surgeon at Dongcheon Donggang Hospital.
◇It does not occur with simple bruises
The upper part of the thigh bone forms a hip joint (hip joint) together with the pelvis. The upper end of the femur, which is in contact with the pelvis, is called the femoral head. Avascular necrosis of the femoral head is a disease in which the blood flow to the femoral head is blocked and bone tissue dies.
The pain begins as pressure is continuously applied to the necrotic bone and the necrotic area fractures. Then, as the necrotic area collapses, damage to the hip joint itself appears. Most people think that if it is left as it is, it can rot even the surrounding bones. However, since the bone is only locally dead, the bone does not directly decompose and does not spread to the surrounding area.
There are various causes of avascular necrosis of the femoral head. Excessive alcohol consumption, steroid (corticosteroid) use, kidney disease, connective tissue diseases such as lupus erythematosus (systemic lupus erythematosus), organ transplantation such as kidney or heart, diving disease, gout, radiation, AIDS (acquired immunodeficiency syndrome) are causative risk factors. In addition, sickle cell anemia or Gaucher’s disease, which is very rare in Korea, can also be a cause.
Kang Seung-woo, an orthopedic surgeon at Dongcheon Donggang Hospital, said, “Even if there are no specific causative risk factors, it can occur due to trauma such as a femoral neck fracture or hip dislocation. However, avascular necrosis of the femoral head does not occur with simple bruises alone.”
◇Similar to herniated disc, misinformation
The problem is that the blood supply to the femoral head is cut off, so even if necrosis occurs, there are no symptoms. Pain in the hip joint, the main symptom, occurs when a fracture occurs in the necrotic area following a considerable period of time has passed following necrosis.
Because the pain usually starts suddenly, you limp when you step on the ground. The range of motion of the hip joint is reduced due to pain and depression of the femoral head, making it difficult to sit cross-legged on the floor. If the depression is severe, the patient himself can feel that the leg length is shortened.
It is similar to the symptoms of a herniated disc or stenosis, so it can sometimes be mistaken for a disease. For this reason, many patients visit the hospital following developing the disease. It is necessary to look closely to distinguish it from a herniated disc, and it is necessary to determine whether there is pain in the inner thigh rather than the lower back, and the discomfort when doing bi-legs.
◇Can be cured with artificial arthroplasty
For the treatment of avascular necrosis of the femoral head, observe the progress if the size of the necrosis is small or the location is good, and if there is pain but does not interfere with daily life. In the early stages, symptoms are relieved by medication to reduce joint swelling, exercise therapy to strengthen muscle strength around the hip joint, and lifestyle improvement.
However, if the range of necrosis is wide and pain makes daily life difficult, follow-up, regenerative surgery, osteotomy, and artificial arthroplasty are necessary depending on the patient’s condition or degree of progression.
Among them, if you are young and the ball head is not depressed, try regenerative surgery. It can also be treated with decompression surgery or bone grafting. Of course, these treatments do not have a high success rate, so they are used to delay or avoid artificial joint surgery rather than the concept of a cure.
Specialist Kang said, “Artificial joint surgery is the most reliable treatment at the moment, and if the patient is over 50 years old, has a lot of pain, and the area of necrosis is large, artificial joint surgery is necessary without regenerative surgery or osteotomy. However, considering the durability of the artificial joint, it is recommended to perform regenerative surgery or osteotomy rather than repeating the operation several times.”
Aplastic necrosis of the femoral head is not a life-threatening disease in itself. However, it is a disease that interferes with daily life as it becomes difficult to walk and painful even to put your feet on the ground. If left untreated, it will lead to surgery, but if you visit the hospital at an early stage, it is also a disease that allows you to consider various treatments while observing without surgery.
Specialist Kang said, “To prevent avascular necrosis of the femoral head, excessive drinking and smoking that interfere with blood circulation should be avoided.” “Above all, early diagnosis and treatment are important. If you experience pain in the hip joint while walking or walking, you should actively seek medical attention.” By Jeon Sang-heon
