Precautions after core decompression surgery like AVASCULAR NECROSIS (AVN) are mandatory. Avascular necrosis (AVN), also called osteonecrosis or osteonecrosis is a condition in which bone begins to die from a lack of blood supply. There are both direct and indirect causes of AVN. To create a personalized treatment plan, your doctor will review your medical history.
Avascular necrosis is a common condition that affects the head and femur. Necrosis can lead to small cracks in the bone that could eventually cause the head to collapse. This condition can cause pain from increased pressure in the bone marrow blood vessels at the site of necrosis.
Core decompression can be used to treat avascular necrosis in the early stages before it leads to joint collapse. It reduces pressure, increases blood flow, and promotes bone healing.
Core decompression can be indicated during the initial stages of AVN if the surface of your head is still smooth and flat. This is done to preserve the native hip joint. To relieve pain and restore function, a total replacement of the hip is necessary if the joint fails to collapse or the decompression fails.
Under general or regional anesthesia, core decompression can be performed. The patient is then placed on their back, in a supine position. Live X-ray imaging aids in guiding the drill position.
A small incision is made at the hip’s outside. The drill is then passed through the neck of the femur and to the necrotic region in the femoral head. To address the entire extent of the lesion, multiple tracts can be drilled. This allows for a reduction in pressure and more room for blood vessels to grow and nourish the existing bone.
Sometimes a bone graft is used to fill the space left in your bone. This can be taken from another part of the body or from the bone bank. Sometimes, a synthetic bone graft is used.
Read More: labor precautions
Post-Operative Care for precautions after core decompression surgery
Crutches will be required for six to twelve weeks after the operation to avoid weight bearing at the hip joint. This is until the femur bone heals fully. After the surgery, you will be able to resume your normal activities three months later.
You were discharged with the following medications:
- Oxycodone 5mg tabs. Take 1-2 tabs every four hours if you have severe pain.
- Tylenol 325mg: Take 2 tabs orally once every 6 hours to relieve pain
- Zofran oral dissolving tabs 4 mg; one tab is all you need. Dissolve under your tongue once every 8 hours for nausea
- Take 50-100mg orally two times daily if you have constipation. You should continue taking Oxycodone until you experience your first normal stool movement.
- Miralax 1 Capful-this medication can be purchased OTC. If you have not had bowel movements in the last 24 hours, you can take 1-2 caps daily as precautions after core decompression surgery.
Read More: sinus precautions after tooth extraction
- Post-op Day #3: You can remove the dressing and apply gauze, xeroform, and small to prevent infection, apply Tegaderm (in a dressing kit) to the wounds. This should be changed every 2-3 days up to your first clinic visit.
- Do not apply bacitracin or any other ointments to the bandage.
- Post-op Days 1-3, you may shower with the clear wrap over the incisions.
- You may take off the dressing on post-op day 3 and shower.
- SHOWER ONLY
- After showering, gently pat dry the area and then apply xeroform and gauze to each incision. This will allow them to dry and heal as precautions after core decompression surgery.
- Avoid soaking the hip in water, or swimming in the ocean or pool for 4 weeks after surgery. After the steri-strips are removed, you can usually take a dip in the pool or bath. If not instructed, the patient may have fallen off within 4 weeks.
Read More: labor precautions
- Feet-flat weight bearing (50% of body weight) for 6 weeks with crutches
- Your physical therapist will help you get off your crutches as one of the precautions after core decompression surgery.
- Take 500mg of Naproxen twice daily orally for one month
- Aspirin 325mg twice daily for 14 days to prevent blood from clotting as medicine in precautions after core decompression surgery.
This is it.
Advantages of Precautions after core decompression surgery
These are the benefits of core compression:
- May prevent the femoral head from collapsing.
- Protects the femoral bones.
- It is possible to delay or even avoid total hip replacement as precautions after core decompression surgery.
Read More: hip spacer precautions physical therapy
Risques and complications
Core decompression, like all surgeries, can be associated with complications such as:
- Fracture along the core track
- Perforations in the femoral heads
- Deep vein thrombosis
Guidelines for Post-Operative Prescription
All prescriptions will either be sent electronically or given the day before surgery as precautions after core decompression surgery. If you require refills, please call the clinic within 48 hours (Monday through Friday 8:30 am to 4:30 pm). No refills will be approved outside these hours. For refills, please have the address or phone number of the pharmacy you wish to use.
- A codeine derivative for pain is one of the medications. It should only be used as directed. The pain may decrease over time. You can decide to stop taking the codeine derivative medication or to reduce the dosage.
- Indocin is another medication that may be prescribed to you. It’s found in the drug NSAIDs (nonsteroidal anti-inflammatory drugs) and is given to patients for 4 days beginning the day following surgery.
- Another medication, Zofran (use according to your needs), will be given to you.
- To prevent Deep Vein Thrombosis (DVT), Aspirin will only be administered for 14 days.
Read More: fall precautions nursing teaching
Common signs of an allergic reaction to prescription medicine as precautions after core decompression surgery include:
- Avoiding bland foods or lying down will not help with nausea and vomiting
- Severe itching
- Severe dizziness
- Slowed heartbeat