Question
Dr. Rusty, in July of 2007, I begin to experience extreme knee pain. Since then I have had Synvisc Injections, Orthoscopy surgery to fix a tear, and two more rounds of Synvisc injections. I am now scheduled to have both knees replaced in Sept. Also, this past summer I had to have my shoulder replaced due to Avascular Necrosis.

My question is there any way that I can determine what triggered all of this destruction in such a short time and is there any tests that I need to do to determine if my hip joints are in the early stages of deteriation. Also, is there research showing a relationship between Avascular Necrosis and arthritis? Thank you.  Barbara

Answer
Barbra,

There is no relationship between arthritis and
Avascular Necrosis is most often caused by trauma. A small fracture prevents blood from properly circulating in the bone causing bone death.  I is impossible for me to say why all of these things are happening at the same time.

The best test for detecting Avascular Necrosis in the early stages is a MRI.

You should talk to your doctor about what he or she thinks was the cause of the Avascular Necrosis in your shoulder. If they think it was trauma related then your are at a very low risk of seeing it in your hips. If it is nontramatic related then having an idea of the things that caused it can help you avoid it again in the future or get treatment if there is an underlying disease or condition playing a role in your developing the cond-tion.

The main causes of nontramatic Avascular Necrosis is smoking, drinking and steroidal drugs (corticosteroids). Avoiding these will lower your risk. There are several diseases and conditions that can cause it as well.

I wish you the best and hope your health improves.

Rusty
http://arthritis-symptom.com/a-c/avascular-necrosis.htm