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From a post by Frusciante 10-14-2004 11:19 PM
Wrong...do a search on "AVN bone death" or "avascular necrosis". It means death of bone. There have been many recent studies showing that either anabolic or cortico steroids cause this disease. Yes cortico steroids do cause this, but so do anabolics. They don't know exactly why it may affect only some people.
Despite the two compounds being totally different makups only sharing the name "steroid" they do share a common side efects. That being they both increase your LDL. The theory right now is the high lipid levels increase the possibility of cutting off the flow in small arteries supplying the ends of the large bones (such as the hip or femur) this causes the bones to die. I know people with is condition and there is no cure. Once the bone is dead, thats it.
I have many articles on this around as I've been reading obout this for quite a while. Ostoperosis is very similar to AVN except its brought on "naturally" via bone loss and the things you've read about lack of calcium vs the AVN being induced through drugs via loss of blood suply to the bones. AVN can also be brought on from scuba diving because of the nitrogen levels reaping havoc with the lipid counts too.
I'll try to post some info later regarding this. I also know some orthos that deal specifically with this issue. Most still don't recognize it. Especially the younger recently schooled ones.
have more accurate ones with better info around somewhere here.
BTW: AVN or avascular necrosis = osteonecrosis (just another name for same thing)
The NIH study did find use of weight training, bodybuilding, and having taken testosterone as risk factors for the development of the disease. But that does not mean people with HIV should kiss their gym memberships good-bye.
"All that we can say is that there is an association between those things," says Kovacs. "Whether it is a direct cause and effect, we can't determine because the numbers in our study are just too small. Maybe it's that people who tend to weight-lift might be those using testosterone, for example, but we just can't answer that based on this study."
Joe believes weight lifting is not a cause of osteonecrosis but may be a contributing factor to the progression of the disease. "Once the AVN has occurred for whatever reason and bone-cell death has taken place, then activities that cause increased forces through the hip joint may be confounding factors."
The hip area tends to be the first place on the body that osteonecrosis develops, although it can also occur in a shoulder, knee, or hand. "Because of the way we're wired," Joe explains, "the hip is an area where vascular compromise can more easily occur because of how blood vessels feed the femoral head." In most parts of the body, there is more than one way blood gets to the bone, Joe notes. But in the anterior portion of the femoral head—the inner side of the top of the hip bone— the blood supply comes in from only one area.
In January 2000 researchers reported that people with HIV were developing osteoporosis as a side effect of treatments for HIV. But while they are both bone problems, osteoporosis and osteonecrosis should not be confused. Bone continually breaks down and rebuilds; osteoporosis, a condition where bones become weak, brittle, and break easily, occurs when the cells do not rebuild as fast as they break down. In contrast, osteonecrosis is a condition where this rebuilding process comes to a halt because blood cannot get to the bone.
"We need that nutrient blood flow to help with the constant bone turnover we have," explains Joe. "Without the blood flow, the cells die, and the complete bone remodeling process doesn't take place, and all that you have is debris and dead bone cells."
Once bone death occurs, the bone is predisposed to further injury. "We've been advising patients who have AVN that they might want to avoid activities that will increase compressive forces through the hip joint like some weight lifting, squats, or carrying heavy weight on their shoulders as well as running on concrete," Joe says, "because that may put them more at risk for advancing the disease, even though there is nothing proved in the literature to show that will help slow the progression."
In fact, according to Kovacs, there are no treatments that indicate that once osteonecrosis is seen on an MRI scan, there is anything that can be done to halt the disease—whether a person is HIV-positive or not. Core-decompression surgery, which removes the inner layer of bone and thereby helps to increase blood flow and allow more blood vessels to form, may reduce pain and slow the progression of osteonecrosis—if the disease is found early on—but it cannot stop it. And once the disease has progressed, hip-replacement surgery is the only method of alleviating the pain.
Severed Ties said:
Wrong...do a search on "AVN bone death" or "avascular necrosis". It means death of bone. There have been many recent studies showing that either anabolic or cortico steroids cause this disease. Yes cortico steroids do cause this, but so do anabolics. They don't know exactly why it may affect only some people.
Despite the two compounds being totally different makups only sharing the name "steroid" they do share a common side efects. That being they both increase your LDL. The theory right now is the high lipid levels increase the possibility of cutting off the flow in small arteries supplying the ends of the large bones (such as the hip or femur) this causes the bones to die. I know people with is condition and there is no cure. Once the bone is dead, thats it.
I have many articles on this around as I've been reading obout this for quite a while. Ostoperosis is very similar to AVN except its brought on "naturally" via bone loss and the things you've read about lack of calcium vs the AVN being induced through drugs via loss of blood suply to the bones. AVN can also be brought on from scuba diving because of the nitrogen levels reaping havoc with the lipid counts too.
I'll try to post some info later regarding this. I also know some orthos that deal specifically with this issue. Most still don't recognize it. Especially the younger recently schooled ones.
have more accurate ones with better info around somewhere here.
BTW: AVN or avascular necrosis = osteonecrosis (just another name for same thing)
The NIH study did find use of weight training, bodybuilding, and having taken testosterone as risk factors for the development of the disease. But that does not mean people with HIV should kiss their gym memberships good-bye.
"All that we can say is that there is an association between those things," says Kovacs. "Whether it is a direct cause and effect, we can't determine because the numbers in our study are just too small. Maybe it's that people who tend to weight-lift might be those using testosterone, for example, but we just can't answer that based on this study."
Joe believes weight lifting is not a cause of osteonecrosis but may be a contributing factor to the progression of the disease. "Once the AVN has occurred for whatever reason and bone-cell death has taken place, then activities that cause increased forces through the hip joint may be confounding factors."
The hip area tends to be the first place on the body that osteonecrosis develops, although it can also occur in a shoulder, knee, or hand. "Because of the way we're wired," Joe explains, "the hip is an area where vascular compromise can more easily occur because of how blood vessels feed the femoral head." In most parts of the body, there is more than one way blood gets to the bone, Joe notes. But in the anterior portion of the femoral head—the inner side of the top of the hip bone— the blood supply comes in from only one area.
In January 2000 researchers reported that people with HIV were developing osteoporosis as a side effect of treatments for HIV. But while they are both bone problems, osteoporosis and osteonecrosis should not be confused. Bone continually breaks down and rebuilds; osteoporosis, a condition where bones become weak, brittle, and break easily, occurs when the cells do not rebuild as fast as they break down. In contrast, osteonecrosis is a condition where this rebuilding process comes to a halt because blood cannot get to the bone.
"We need that nutrient blood flow to help with the constant bone turnover we have," explains Joe. "Without the blood flow, the cells die, and the complete bone remodeling process doesn't take place, and all that you have is debris and dead bone cells."
Once bone death occurs, the bone is predisposed to further injury. "We've been advising patients who have AVN that they might want to avoid activities that will increase compressive forces through the hip joint like some weight lifting, squats, or carrying heavy weight on their shoulders as well as running on concrete," Joe says, "because that may put them more at risk for advancing the disease, even though there is nothing proved in the literature to show that will help slow the progression."
In fact, according to Kovacs, there are no treatments that indicate that once osteonecrosis is seen on an MRI scan, there is anything that can be done to halt the disease—whether a person is HIV-positive or not. Core-decompression surgery, which removes the inner layer of bone and thereby helps to increase blood flow and allow more blood vessels to form, may reduce pain and slow the progression of osteonecrosis—if the disease is found early on—but it cannot stop it. And once the disease has progressed, hip-replacement surgery is the only method of alleviating the pain.
