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AVN stage 1
Hi,
I have attached my father's report, age 60. He has diabetes with hb1ac 7.2. He has pain in thigh (usually at night) and AVN stage 1. I consulted with doctor, he said total hip replacement is required. But when I went for second opinion to another doctor before surgery. He said pain is due to meralgia paresthetica and pain will not go with THR. Am really confused should I go for THR. Doctor has prescribed pregabalin, can medicine cure meralgia paresthetica?
Answers (7)
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For avn stage 1, we can do hip Arthroscopy intervention. For meralgia parasthetica, steroids and pregabalin
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In this case continue PREGABALIN FOR 4 WEEKS
If pain continue even after 4 weeks CORE DECOMPRESSION IS BETTER OPTION
CLINICAL EVALUATION OF PATIENT IS NEEDED
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A few details required-
1. Any history of smoking/ alcohol intake
2. Can he sit cross legs( palthi / chokdi in local language)
3. Before THR we can go for core decompression ( a minor surgery)
4. I can try with some unique medicines. I already treated a few with these medicines.
Next Steps
Try with medicines
Health Tips
Quit smoking ( if doing)
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It's better to see the MRI flim rather than the reports in these cases (Also x rays help).
Next Steps
Needs a clinical evaluation firstly
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Depending on multiple factors the plan can be decided
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Meralgia paresthetica seems unlikely, needs clinical examination /ruling out other causes and even if it is, it should subside with medicine.
Trusting the MRI report which mentions a FICAT 2 Avn , causes of Avn need to be ruled out .
Can give a trial of medicines and may try core decompression in that stage since there is no mention of collapse or secondary osteroarthritis of hip.
Next Steps
continue pregabalin for couple of weeks; add tab nucoxia P twice daily for 5 days . if it doesnt settle then needs to b evaluated , pros and cons of both (core decompression vs THR) to be discussed, and can proceed thereafter accordingly.
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Dr. Rahul Kumar Pandey
Orthopedic surgeon
10 yrs exp
Lucknow
In AVN stage 1, the femoral head is still structurally preserved and THR is usually not the first line of treatment.
Yes,medicines like Pregabalin can help relieve symptoms of meralgia parasthetica.
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Dr. Ravikumar Chandulal Makadia
Orthopedic surgeon
6 yrs exp
Ahmedabad
Its stage 2..
Hip replacement best option
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Disclaimer : The content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding your medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.