HanoiMr. Hai, 25 years old, regularly drank a lot of alcohol, causing blood vessel blockage, leading to necrosis of the femoral heads on both sides, requiring hip replacement surgery.
Mr. Hai, living in Son La, works as a driver. For the past two years, he has had pain in his hip every time he gets in and out of the car. He can’t ride a motorbike. He can’t sit with his legs crossed while eating. He has to prop his feet up. He often has insomnia due to the increasing pain. heavy at night. When resting, the pain decreases, but with more activity, the pain returns. He took a lot of medicine and it didn’t help, and he could barely walk.
On April 27, M.D. Nguyen Quang Ton Quyen, Deputy Head of the Department of Trauma and Orthopedics, Tam Anh General Hospital in Hanoi, said that Mr. Hai had end-stage necrosis of the femoral head and did not respond to secondary osteoarthritis. Drug reaction, collapse of the femoral head, appointment for bilateral hip replacement surgery.
According to Dr. Quyen, 80% of femoral head necrosis occurs in men, most commonly at the age of 40-50. However, the disease tends to rejuvenate, the proportion of patients under 40 years old is increasing, and in some cases under 30 years old, artificial hip replacement surgery has been performed. The cause is alcohol abuse, tobacco, drugs containing corticosteroids or autoimmune diseases.
Doctor Quyen further explained that in Mr. Hai’s case, alcohol was the main cause of injury. The patient is young and very active, so the need for blood supply to the femoral head is very high. Patients drink a lot of alcohol for a long time, about 300-1,500 ml/day, especially alcohol that has not yet eliminated all the toxins, causing poisoning and clogging the capillaries that feed the femoral head. Bone and cartilage cells in the capitellum area become anemic, leading to gradual necrosis. The initial necrotic area is an area of sparse bone and bone defects, gradually causing subchondral fractures, collapse of the femoral head, loss of hip joint function, and the most severe is disability.
The biggest risk when replacing joints for young patients is joint wear, leading to joint loosening and the possibility of needing surgery to replace a new joint. “This joint replacement requires strict technique, ensuring the exact position of the joint components, avoiding the risk of a second joint replacement,” said Dr. Quyen. Joint components must be in the optimal position to increase coverage and minimize joint wear.
The patient had joint replacement surgery using the Superpath incision. The surgery is quick, has little pain, reduces soft tissue damage, and has a low infection rate. Especially, the patient can be discharged from the hospital in less than 24 hours after surgery.
A team of doctors from the Department of Orthopedics performs surgery on a patient. Illustration: Tam Anh General Hospital
According to Dr. Quyen, minimally invasive surgical techniques like Superpath combined with the development of physical therapy and rehabilitation help shorten recovery time. Patients only need to stay in the hospital for observation one night after surgery and can go home the next day.
Two weeks after surgery, Mr. Hai no longer had pain, could walk without using crutches, perform daily activities, and even drive a motorbike.
Doctor Quyen noted that for patients with end-stage osteonecrosis of the femoral head, despite their young age, hip replacement is the only solution to end chronic pain and restore movement.
To prevent disease, you should minimize alcohol and quit smoking; Nutritionally balanced diet, increasing fruits and vegetables and limiting fat. People with medical diseases such as blood pressure, blood lipids, blood sugar… need to control their diseases; Do not abuse drugs containing corticosteroids. In the early stages, femoral head necrosis can be successfully treated with medication or decompression drilling surgery as prescribed by your doctor.