Yamaguchi Tatsuya Reveals Avascular Necrosis Diagnosis and Its Links to Alcohol Dependence

“My femur bone is rotting.”

“If the pain gets worse like this, I’ll need an artificial joint. They say this can’t be cured. When I looked at the X-ray, it had turned black.”

Former TOKIO member Yamaguchi Tatsuya (54), who has been holding lectures across Japan for local governments and other organizations on themes such as the dangers of addiction and social reintegration from addiction, based on his own experience with alcohol dependence, has recently begun mentioning in his talks that he has developed femoral head necrosis in his right hip joint, drawing attention in various places.

At present, Yamaguchi is said to be barely managing daily life, but if severe pain appears, a total hip replacement surgery will be required. This relatively unfamiliar illness is a serious condition that is also included among Japan’s designated intractable diseases under the Ministry of Health, Labour and Welfare.

In recent years, the number of patients undergoing this artificial joint replacement surgery has been increasing. Behind this trend, Dr. Kazutoshi Kameda, director of Sapporo Central Orthopedic Clinic, points out that there is a problem that tends to be overlooked (the following quotes are from Dr. Kameda).

That problem is alcohol dependence. Yamaguchi himself has described his femoral head necrosis as being caused by alcohol.

The bone quietly collapsing

“Femoral head necrosis is a disease in which bone gradually dies due to impaired blood flow. The femoral head at the root of the thigh is an extremely important part that supports body weight. When blood no longer reaches this area, bone cells undergo necrosis. However, necrosis itself often does not cause pain. What is truly frightening is when the necrotic femoral head can no longer support body weight and collapses inward. Only then does severe pain occur.”

“—The bone is dying.”
Despite this powerful expression, the disease progresses astonishingly quietly. Without noticing, the joint is steadily destroyed.

The relationship between alcohol and bones, which at first glance seems unrelated, has already been medically established.

“In the diagnostic criteria and research for idiopathic femoral head necrosis:

・Continued consumption of 320g or more of pure alcohol per week for at least 6 months

・Long-term drinking equivalent to 2 go of sake per day (about 40g of pure alcohol) or more

These are clearly listed as risk factors. There are also reports that people who drink three or more 350ml cans of beer daily have about a tenfold increase in risk of developing the condition.”

There may be more people who fall under this category than expected.

Long-term heavy drinking does not end only as a problem of addiction.

“Alcohol causes blood flow impairment and lipid metabolism disorders. Not only do small blood vessels inside the bone become blocked, cutting off blood supply to the femoral head, but direct toxicity to bone cells is also thought to be involved. In this way, the bone collapses from within.”

Alcohol dependence is a systemic disease that affects not only the brain and liver, but even the bones.

Surgery does not mean it ends

The real danger of this disease is that there are almost no early symptoms. As a result, diagnosis is often delayed.

“In the early stages, there are almost no symptoms. It is often overlooked as just a slight discomfort or mild pain, and by the time the pain becomes strong, in many cases necrosis has already progressed and collapse of the femoral head has already begun.

When it comes to alcohol dependence, liver cirrhosis and dementia are well known, but cases that manifest as femoral head necrosis are by no means rare. It is, in a sense, a hidden complication.”

If necrosis progresses and the femoral head collapses, the only remaining option is total hip replacement surgery.

“By replacing the damaged bone with an artificial joint, pain relief and recovery of walking function can be expected.”

However, surgery does not mean that everything is resolved.

“In recent years, artificial joints have improved in materials and design, and durability of over 20 years can be expected. However, artificial joints do have a lifespan. Especially when surgery is performed at a relatively young age, it is necessary to understand realities such as:

・the possibility of future revision surgery

・complications such as infection or dislocation

・lifestyle restrictions such as avoiding excessive load

Strenuous exercise and excessive stress must be avoided, and long-term follow-up is essential. In other words, the body does not return to its original state.”

The cost of alcohol dependence is extremely large: brain atrophy, cognitive decline, liver cirrhosis, and bone necrosis. All of these are irreversible damages.

Yamaguchi Tatsuya, former TOKIO member, who has overcome alcohol dependence and is now engaged in awareness-raising activities, is likely to be once again confronted with the harsh reality of alcohol through his diagnosis of femoral head necrosis.