ZocdocAnswersCan I walk normally without a femur head?

Question

Can I walk normally without a femur head?

I had avascular necrosis of the femoral head and am HIV POZ and have MRSA. will I ever be able to walk without an assistive device. also am I totally excluded from hip replacement surgery. MD says the shaft of my femur is growing into the area where my femur head was is this bad or good and its all healthy bone. Help me please.

Answer

It sounds like you have a complex medical history and a very challenging problem (avascular necrosis) to treat, but there are several options available to you. Because of the complexity of the problem you would benefit most from a consultation with an experienced orthopedic surgeon (likely at an academic medical center) who has the training and resources available to treat a patient in your situation. The first option is to "live with it", meaning to attempt to adapt to using an assistive device. Many people are able to function well with the help of assistive devices, and this option represents a reasonable and (perhaps most importantly) low risk option. If your goal is to walk without an assistive device, you will likely have to consider a surgical procedure. These options include a procedure to stimulate re-vascularization of your femoral head (only an option in specific situations, so you may not be a candidate), hip fusion (rarely performed today, but it may be an option depending on your physical demands), and hip replacement. Historically hip replacements in HIV positive patients had a higher rate of complications, but outcomes have improved in recent years. Whether or not you are a good candidate for any of these procedures depends on many factors (how well controlled your HIV is, your other medical co-morbidities, your age and functional status, your access to a surgeon who is comfortable with treating such complex patients, et cetera), but I would not give up hope. In a situation such as yours it is prudent to speak with the doctor managing your HIV (who may know which orthopedic surgeons in your area are comfortable with this type of problem), as well as to seek the opinion of multiple orthopedic surgeons prior to choosing a treatment plan.

This answer is for general informational purposes only and is not a substitute for professional medical advice.

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