Stage 4 of osteonecrosis is the most severe form of the condition, and is typically the result of long-term damage from untreated or inadequately treated stages 1-3. At this stage, the bone has deteriorated to the point where the only treatment option is total joint replacement, as the bone has been completely destroyed.
Symptoms of stage 4 osteonecrosis include severe pain, stiffness, swelling, and limited range of motion. In some cases, the affected joint may become deformed and the patient may not be able to bear weight on the joint. X-rays can confirm the presence of stage 4 osteonecrosis, and a MRI or CT scan may be used to determine the extent of the damage.
Treatment for stage 4 osteonecrosis typically involves total joint replacement surgery, where the damaged bone and joint are removed and replaced with artificial implants. This is a major surgical procedure, and requires a significant recovery period. After the procedure, physical therapy is necessary to help the patient regain strength and mobility in the joint.
In some cases, the patient may be a candidate for a less invasive procedure known as core decompression, which involves drilling small holes in the bone to relieve pressure and allow blood to flow to the affected area. This procedure can slow the progression of the disease, but is not a cure and typically does not prevent the need for total joint replacement.
Stage 4 osteonecrosis is a serious condition that requires immediate medical attention and intensive treatment. With proper diagnosis and treatment, the progression of the condition can be slowed and irreversible damage can be prevented.