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Dysbaric osteonecrosis (DON) is the destruction of bone tissue in the long bones, hips and shoulders associated with diving and compressed-air work. Dysbaric osteonecrosis is a term used to describe aseptic or avascular bone necrosis due to ischemia caused by gas bubbles, although the exact mechanism is. Dysbaric osteonecrosis (DON) was first identified in the s and was found to be relatively common in the s and early s in some.

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History of decompression research and development History of scuba diving Researchers in underwater diving Timeline of diving technology. Edaravone, a novel free radical scavenger, prevents steroid-induced osteonecrosis in rabbits.

The pathophysiologic role of fat in dysbaric osteonecrosis. Thus, it is possible to state that technical diving itself does not carry a higher risk of DON as long as decompression rules are strictly obeyed. Atmospheric pressure diving Freediving Saturation diving Scuba diving Snorkeling Surface-supplied diving Unmanned diving. So far there are 33 divers in this cohort.

Dysbaric osteonecrosis: a reassessment and hypothesis.

Gallery of photos Examples of the clinical practice. Thank you for submitting a comment on this article.

Etiological and isteonecrosis concepts. Symptomatic lesions in other anatomic reasons can sometimes be treated with curettage and bone grafting. Pain and disability are related to the damage of joints. What are the risk factors for DON? Engineering dysvaric health in compressed air work. Average levels of haematological factors examined here in the normal population were not clarified.


Such patients usually require joint replacement, which involves major and expensive surgery. The results of univariate logistic regression analysis are detailed in Table 1. Smoking is strongly discouraged because it predisposes to both diving- and nondiving-related diseases.

Dysbaric osteonecrosis

The combined use of an anticoagulant and a lipid-lowering agent has been shown to prevent steroid-induced osteonecrosis in rabbits [ 18 ]. Importantly, however, not all series have found a correlation between dysbaric osteonecrosis and ‘the bends’.

Support Center Support Center. White 1 ; Jeffrey S. Asphyxia Drowning Hypothermia Immersion diuresis Instinctive drowning response Laryngospasm Salt water aspiration syndrome Swimming-induced pulmonary edema. Further study will be needed to determine the significance of coagulation in DON. Meet the Experts Emmanuel Gempp, M.

Affilations 1 Louisiana State University. Charles Wesley Shilling Edward D. Our preliminary data showed that the PAI-1 level of five healthy volunteers four men and a woman, age Dysbaric osteonecrosis DON is the destruction of bone tissue in the long bones, hips and shoulders associated with diving dywbaric compressed-air work.

The risk increased with greater deviations from safe decompression procedures. Diving should be restricted to shallow depths. The patient may report pain that radiates from the joint down the limb as well as restriction of the range of motion.


A questionnaire was used to obtain personal clinical information that included age, history of bends and paraplegia, smoking and alcohol consumption. However, in the past five years only two nonmilitary, noncommercial divers using trimix were treated for musculoskeletal DCS in our hyperbaric center.

Dysbaric osteonecrosis – Wikipedia

Diving medicineOccupational medicine. Radiological and pathological features of both dysbaric and non-dysbaric osteonecrosis are indistinguishable and both are characterized by intramedullary venous stasis, ischemia and necrosis of bone. Multivariate logistic regression analysis showed that high levels of PAI-1, a coagulation marker odds ratio 4.

High PAI-1 levels may potentially have been present in divers before their repeated decompressions. I am not aware of any published study on DON screening among technical divers, but prevalence is very low among military divers, who generally dive deep and conduct longer decompressions using mixed gas.

PMC ] [ PubMed: When evaluating early necrosis, there may be a loss of nuclear staining of marrow cells and the appearance of large, ovoid, fat-containing spaces appear.


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