Case 1: 40-year-old male patient. The patient used steroids after sarcoidosis in 1992 and due to this, for about 2 years, for the last 3 months, the patient had aching and sleepless hip and groin pain, which was more severe for the last 3 months, and was diagnosed with bileteral FAVN by orthopedics, and did not accept surgical intervention. He was referred to treatment units and his VAS value was 9-10 when he came to us.
Case 2: 42-year-old male patient. This patient was operated for avascular necrosis of the left femoral head 1 year ago, but due to the relapse of the right hip pain, he went to an orthopedic specialist, where surgical intervention was recommended again. When this patient came to us, his VAS value was 9-10.
In both cases, in addition to the rehabilitation program consisting of weight reduction exercises, isometric or resistance muscle strengthening exercises for related muscle groups, balance coordination exercises, caudal epidiral block and femoral intra-articular injection were applied by the algology unit. The cases benefited clinically from these treatments. (with 1-3 months control) VAS value decreased to 1-2. Radiologic imaging improvement was detected in control MRIs.
Discussion: In the treatment of FAVN cases, a multidisciplinary approach should be approached and physical therapy and algology units should be included in addition to orthopedics. Sympathetic blocks made by algology are beneficial in such cases by increasing revascularization by vasodilation. Here, the operation can be delayed after the treatments to be performed by the physical therapy and algology units before the operation. The patient’s quality of life can be improved.
Conclusion: The aim in FAVN cases is not to restrict the patient’s quality of life and to maintain a pain-free life. Therefore, the operation is the last form of treatment to be planned. In such patients, applying the treatments of physical therapy and algology should be a priority.
