Steel Nation wrote:
You don’t provide an excess of information, but it sounds like you have osteonecrosis of the femoral head. This is a vascular condition promarily and is worsened by high intramural (within the bone) pressure caused by (amongt other things, corticosteroids, which release fat into the blood, causing occlusion of the microvasculature within the head of the femur.
Now it’s been a while since I looked at this and I had a late night last night, but I don’t think GH is really the drug choice for you.
You see, it’s not like you have a local, regional or general loss of bone mineral density. So it’s not like you have excess osteoclastic (BMD reducing) activity, or a reducation in osteoblastic (BMD increasing) activity. Instead, you have (from memory - hope it is correct) localised bone tissue death, caused by lack of blood supply.
I would think that blood thinners might allow some degree of resupply of blood, but if it’s too late, then the bone graft is probably the best option. One that has been done, then tes, re-integartion if the bone matrix into the resectioned area is important, but what about isolating the cause of the blood supply issues?
I know that often Drs label this as ‘ideopathic’ but I suspect there is always a cause - it depends just how dedicated the Dr is to finding it.
The osteonecrosis is the result of trauma to the femoral head (hip dislocation) and the associated vasculature. This occurred about 22 months ago, and progression was visible on MRI at 18 months. It is the opinion of the docs at Duke Medical that I have the graft done, and since they are the world experts on the matter I am doing what they say.
Since the surgery basically involves coring out the dead bone from the femoral head and filling the space with living bone, I thought it might be a possibility that GH could be used to aid in the recovery process by speeding up the rate of bone growth.
Obviously it is entirely possible that I am way off base here.
Ah OK, the trauma part was the missing link in terms of patient history.
As long as the ON is not of unknown cause then a bone graft should not be a wasted procedure.
And yes, GH should assist in the healing phase as well as the remodelling phase (which lasts about 18-24 months BTW).
2 x 2iu E3D should do it, as long as you inject at least i.m. and preferrably i.v.
Thanks a lot for the help. I appreciate it.
One more question: Why is IV preferable to IM?