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Avascular necrosis

Avascular necrosis

Avascular necrosis, also called osteonecrosis is a condition in which bone death occurs because of inadequate blood supply to it. Lack of blood flow may occur when there is a fracture in the bone or a joint dislocation that may damage nearby blood vessels. Chronic use of high doses of steroid medications and heavy alcohol consumption are the two main risk factors of avascular necrosis. Initially, small breaks appear in the bone that may eventually collapse. The hip joint is most commonly affected; however, the knee and shoulder may also be involved.  

The symptoms can appear suddenly. In other situations,  pain and stiffness may gradually appear over a period of time. Typically, avascular necrosis causes pain and restricted range of motion in the joint effected. Your doctor will diagnose the condition using imaging tests such as X-rays, MRI scan and bone scan.

The treatment for avascular necrosis aims at preventing further damage to the bone and the success of treatment it depends on the extent of bone damage that has occurred already. Conservative treatment may reverse early stages of avascular necrosis whereas surgical treatment may be required in more advanced stages.

Conservative approach

Medications: Non-steroidal anti-inflammatory drugs (NSAID’S) may be prescribed to help control your pain and swelling

Rest: Restriction of physical activities and use of crutches to decrease weight bearing on your joints may be beneficial

Exercises:  Regular exercises that improve your range of motion may be done

Surgical Treatment

Core decompression: During this procedure, a fine drill is passed into the involved bone to relieve the pressure inside the bone. This decreases the pain and allows growth of new blood vessels

Bone re-aligning (osteotomy): This procedure is done in advanced stages and involves re-aligning the bone to decrease the stress placed on the effected bone.

Joint replacement: Joint replacement surgery is done as a last resort when the bone has collapsed needing artificial replacement

  • American Association of Hip and Knee Surgeons (AAHKS)