It may seem like I cover osteonecrosis (ON) a lot: I do! Osteonecrosis is real, it is a disabling complication of lupus, and it’s very personal because I have it most joints. Osteonecrosis (or avascular necrosis=AVN) occurs when blood flow to the bone is cut-off and the bone dies. This painful condition has many causes, and lupus can be one cause by a) directly causing blood clots to form which prevent the flow of blood to nourish the bone with oxygen and nutrition, as in Antiphosholipid Syndrome. Lupus can also:
2) interfere with fat metabolism so that fatty clots form. This is one hypothesis when a patient takes Prednisone. One theory is that Prednisone™ interferes with fat metabolism, resulting in the formation of a fatty clot which can in turn cause ON.
3) cause a blood clotting disorder and that blood clotting disorder can result in clots which, in turn, can result in osteonecrosis. This often depends on the organs affected by lupus.
There was a time when ankle replacements were contraindicated in patients who had ON because of the lack of viable bone above or below the talus (ankle bone) for even the best surgeons to anchor ‘to.’ However, recent advancements in the treatment of ON have lead patients to travel to see physicians who are on the cutting edge of treatments and for those physician entrepreneurs to develop new innovative treatments.
I know of one person who traveled several times to France; For my ankle osteonecrosis, I’m going to consult with one of the surgeons in this brief video.” They describe one of four different types of total ankle replacement. NOT GRAPHIC CONTENT AT AlL:
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