Osteonecrosis And The Death Of Bones | Illness and Health Blog | Wellescent.com Guest article

Of the resources necessary to sustain human life, oxygen is by far the most critical. Within minutes of the oxygen in our tissues being depleted, any oxygen-starved cells will begin to die. Because oxygen is delivered to our cells by the blood in our circulatory systems, the cause of oxygen starvation in our body tissues is usually a blockage of blood flow. The most readily recognized health problems caused by this severe lack of oxygen in our tissues are heart attacks and strokes.

While these well-known health issues certainly demonstrate the destructive result of oxygen starvation, lack of oxygen to other tissues can also have serious consequences. On such example is the relatively rare but debilitating condition of Osteonecrosis.

We do not typically think of the bones as tissues with blood flowing in them, but our bones do contain many living cells that are served by the circulatory system.  Some of these cells function in maintaining the structure of our bones. When the cells within our bones are starved of oxygen, they too will die. The death of these maintenance cells means that the bone structure will degrade over time.

Osteonecrosis or avascular necrosis, as it is also known, occurs most frequently in the knees, hips and the shoulders. However it is also seen in the jaw and in the vertebrae of the back. When it occurs in the back, it is known as Kummel’s Disease. The condition most often occurs in those aged 30 to 50 and between 10 to 20 thousand new cases are reported in the US each year. Occurrence of the disease in the hip is one of the more common situations.

For people who experience a low oxygen event or infarction of the bone tissues, what accompanies the bone degradation is often pain and significant arthritis. In many cases, when the disease occurs in the hip, the only option is hip replacement surgery. Likewise, a serious occurrence in the back or jaw will also require surgery to remove and potentially replace the dead bone. Because of the poor blood flow in the first place, surgery to treat Osteonecrosis can often have poor results.

While there are many potential causes of Osteonecrosis, medical research has identified a number of key contributing factors. In 2008 and 2009, there was considerable concern over the use of drugs called bisphosphonates commonly prescribed to slow the onset of Osteoporosis. Subsequent studies by Kaiser Permanente have determined that the risk of developing Osteonecrosis is more than 15 times higher for those on bisphosphonates than those who do not take the drug.

While this is certainly a risk, less than 1 in 1000 people on these drugs will suffer from Osteonecrosis. The issue is that with roughly 44 million Americans being treated with bisphosphonates because of Osteoporosis risks, even low rates mean a considerable number of people will be affected. It also means that patients on such drugs need to ensure that their doctor is actively monitoring them.

One other well-recognized cause of Osteonecrosis is from high levels of alcohol in the blood. Alcoholism and less frequently, bacterial infection, can cause toxic alcohol levels that can kill the cells within the bones also leading to the disease. In the case of alcoholism, however, Osteonecrosis is but one of the serious consequences of having persistently high levels of blood alcohol.

Another contributing factor for the development of Osteonecrosis is as a result of medical steroid use. The steroids commonly used to treat Asthma, some kidney diseases, rheumatoid diseases and Ulcerative Colitis can lead to both Osteoporosis and Osteonecrosis as a result of prolonged use at higher dosages. In a study published in the Journal of Bone and Joint Surgery in 2008, researchers found that 40% of patients treated with high doses of steroids during the SARS epidemic went on to develop Osteonecrosis. This study highlighted the risks to those on high levels of these drugs.

Related to steroid use, another factor for increased risk of Osteonecrosis is amongst those with autoimmune disease. In particular, those with Rheumatoid Arthritis and those with Lupus have an increased risk for developing the disease. Subsequently, the use of immunity-suppressing steroids futher increases the risk that these individuals face. This means that patients with autoimmune disorders should be especially careful in ensuring that their doctor are keeping tabs on their medication levels.

While Osteonecrosis is certainly a relatively rare condition, it is very debilitating when it does occur. Patients affected by the condition typically have few, if any, treatment options. Because we are dealing with bone, the treatment possibilities that do exist can involve significant procedures. In most cases, the cause of the disease is from medications so it is important for patients to ensure that they are being monitored by their doctor to minimize the risks that they face.