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Dysbaric osteonecrosis in technical divers: The new 'at-risk' group?
Brendan Coleman1,2, F Michael Davis3
1Auckland Orthopaedic Practice, Auckland 1543, New Zealand.
Diving and Hyperbaric Medicine
|September 21, 2020
Summary
Dysbaric osteonecrosis (DON) is a risk for technical divers. Medical review for DON is recommended for this high-risk recreational diving group due to increased exposure factors.
Area of Science:
- Diving Medicine
- Occupational Health
Background:
- Dysbaric osteonecrosis (DON) is documented in workers exposed to increased atmospheric pressure.
- It is less common in commercial divers than caisson workers, but prevalent in indigenous diving groups lacking decompression knowledge.
- Technical diving's rising popularity may increase DON cases in recreational divers.
Observation:
- A case of bilateral humeral head DON in a technical diving instructor with 30 years of deep diving experience is presented.
- The instructor required a hemi-arthroplasty for the condition.
- A literature search identified other DON cases in recreational divers.
Findings:
- DON risk factors include exposure frequency, duration, depth, inadequate decompression, and age.
- These factors were present in the reported technical diver.
- DON is uncommon in recreational scuba divers but risk factors are amplified in technical diving.
Implications:
- Technical divers represent a high-risk group for developing DON.
- Periodic medical evaluations for DON are advised for technical divers.
- Understanding and mitigating decompression risks is crucial for preventing DON in technical diving.
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