How Hyperbaric Oxygen Helps Treat Avascular Necrosis

We all need oxygen to live, but you might not think of its importance when it comes to conditions that affect our bones.

Bones, which are made of different types of cells, proteins, and minerals, need a steady supply of oxygen-rich blood to stay strong. When the blood supply to the bone is interrupted, it can cause the bone tissue to die—a condition known as avascular necrosis.

Hyperbaric oxygen (HBO) therapy is a treatment for certain emergency conditions, including infections, trauma to the body, and diabetic ulcers.

“It is also used to treat wounds and other injuries where there is tissue scarring or death, for example, from radiation,” says Rummana Aslam, MBBS, a Yale Medicine specialist in physical medicine and rehabilitation. “HBO restores the continuity of tissues and circulation; it is a regenerative tool.”

For HBO therapy, the patient lies or sits inside a sealed hyperbaric chamber with higher atmospheric pressure than at sea level. HBO therapy is particularly useful for people with avascular necrosis in combination with stem cell treatments.

“Stem cells are very beneficial to avascular necrosis because they can help repair the damaged blood supply and the dead bone,” says Daniel Wiznia, MD, a Yale Medicine orthopaedic surgeon. “At Yale, we harvest the stem cells from the patient's bone marrow in their pelvis. We take some of that bone marrow. During the surgery, we process it in a centrifuge, and we can isolate and concentrate down the stem cells.”

Because hyperbaric oxygen stimulates stem cells, combining HBO therapy with surgery gives the body the best chance of regrowing blood vessels, Dr. Wiznia explains.

Each HBO treatment lasts two hours and is done five days a week. Ten sessions are done before surgery and 20 after.

“It is a very safe treatment,” Dr. Aslam says.

In the video above, the doctors talk more about hyperbaric oxygen treatment for avascular necrosis.