Aseptic bone necrosis
(e.g. Femoral head avascular necrosis and Morbus Ahlbäck disease)
Aseptic bone necrosis, osteochondrosis or osteomyelitis are mostly spontaneously occurring disorders of bone or cartilage deterioration, often at the hip joint of the femur, on the knee joint or on the tibial plateau (Morbus Ahlbäck).
Pathophysiology (original causes)
Based on current knowledge, this is a multifactorial event, in which disruption of the local blood circulation as well as genetic factors play a role. Risk factors include: accident, coagulation disorders, obesity, pregnancy, cortisone medication, longterm damage of workers exposed to overpressure or from diving, neurological diseases, diabetes or alcoholism.
First symptoms are sudden pain felt in the affected joint area, or under loaded pressure (e.g. going upstairs) as well as at rest, typically at night. At a later stage, movement is restricted.
The stages of Morbus Ahlbäck disease
The disease is divided into stages according to ARCO:
Efficacy of HBO therapy
HBO therapy is a form of treatment whereby the patients inhale medically pure hyperbaric oxygen (HBO = hyperbaric oxygenation). In a hermetically sealed chamber, pressure is increased from 1.5 - 3 times the normal atmospheric pressure. Normally, the oxygen in the air binds itself to the red blood cells and is transported from the blood stream to the tissues. The diseased or injured organism can only maintain this oxygen supply to a limited extent and the oxygen is unable to penetrate the tissues sufficiently. Under the conditions of HBO therapy, the oxygen is absorbed by the blood plasma, as well as by the red blood corpuscles. As a result, the penetration depth of the oxygen into the tissue is increased by up to 4 times, and the tissue which has been damaged under normal conditions is again supplied with sufficient oxygen.
In the case of a reduced blood circulation in aseptic bone necrosis the following therapeutic effects can be expected:
• Reduction of an existing bone oedema by vasoconstriction. New blood vessels are formed.
• Connective tissue-forming cells are activated and connective tissue fibres are produced in greater quantities.
• Stimulation of the cells responsible for bone reabsorption and bone building lead to bone regeneration.
The individual therapy
Together with your doctor, the pressure chamber doctor will work out a treatment programme specifically for your medical conditions. Doctors and patient work “hand in hand”. The patient should comply with any lifestyle and medication recommendations by the treating physician. The HBO therapy ensures wound healing with the enrichment of oxygen in the tissue.
The different stages affect the type of treatment needed.
Reimbursement of costs
Private health insurance companies and the benefits office make their decisions according to individual requirements of the insured person. As a rule the costs are met. They are based on the statutory scale of medical fees for physicians (GOÄ).
Statutory health insurance companies pay for the treatment only in exceptional individual cases. Before each treatment, we prepare a detailed cost estimate. Treatment is usually started after cost clarification and medical examinations have been carried out.