Here's my experience and what I currently know about osteonecrosis:
-Most trauma related cases have an underlying clotting disorder (I have anticardiolipin syndrome)
-yes, a single case of DCS or even without obvious DCS (rarely) can activate the clotting cascade and cause osteonecrosis ( in my case, I think I also had an undiagnosed case with strange joint pains,probably from a huge amount of steroids given for illness 7 years ago). I went diving on Catalina ( not the first or most aggressive dive trip since then either) but something that trip-aggressive,cold repetitive diving and boom, no longer walking, but never really typical of DCS. Pain gradually worsened over the next few months, worst pain than I could imagine, like nothing I've ever experienced, even with a broken/unstable neck fracture
- I had knees, ankles and a painful elbow, with negative MRI of the elbow but definite elbow symptoms, the elbow finally resolved after a year of anticoagulation and an immune therapy-Plaquenil
-joint replacements are usually required within 3 months but some treatments such as blood thinners and stem cell surgeries may help-in my case, I had both, aggressive blood thinning and stem cell surgeries with big improvements and elbow/ankles healed with no surgery, ankles showed smaller but still present spots
-joint replacements tend to be problematic with bigger lesions and very rarely amputation will be necessary
-multiple joints is exceedingly rare and the only doctors that I've found who have seen it are osteonecrosis specialists, of which there are a small,very small handful. I've only found a very small handful of people with this issue by joining a Yahoo group. Most have a single joint, usually a hip, usually trauma related
-long time divers seem to get ON in the shoulders
-I have no idea why this guy is given a short lifespan, maybe more to do with stroke?
I'm doing very well now, getting ready to start diving again after 18 months. I still have some knee pain and swelling but considering that it took me almost 6 months from when this all started to my stem cell surgeries and anticoagulation, I feel incredibly lucky to be doing so well. I suspect that I might need knee replacements down the road but right now my knees are strong, it's just the pain and swelling. The blood thinners and plaquenil have really helped and without the stem cell surgery, I'm sure I would have needed multiple joint replacements within a very short time. I'm just now getting back to full-time work after 18 months off.
The stem cell surgeries were difficult, very painful and required 6-8 weeks total non-weightbearing, which meant the first surgery kept me entirely in a wheelchair. After the second surgery I was able to use a walker or crutches since my first knee was doing better. I had the surgeries 7 weeks apart since it was fairly urgent and things were going downhill by the day.
This is not something I would wish on my worst enemy. It is a terrible, painful disease. The patients I've seen with only a single joint are often on huge quantities of fentanyl or morphine, more than I've seen with even bone cancer.
---------- Post added November 13th, 2014 at 05:12 PM ----------
I wish him well.
This says it can be caused by temporary loss of blood supply to the bones, it also says it can be caused by steroid use.
Questions and Answers about Osteonecrosis (Avascular Necrosis)
I did find this part of the story rather odd though.
"He thought he must have pinched a nerve and wanted to take a Tylenol pill to alleviate his body,"
The article looked like it was written by a 3rd grader.
