Avascular Necrosis


What Is Avascular Necrosis?

Avascular necrosis(AVN) is a bone disease marked by the loss of the crucial supply of blood to deliver nutrients and gases to the bone. This dead or dying portion of a bone may have been caused either by an injury, disease or the side effects from a drug. When the blood supply is interrupted to any portion of the bone, that portion dies and is labeled avascular necrosis, commonly occurring in the hip but also in the knee.  Approximately 10,000 people are diagnosed with avascular necrosis each year in the United States with more than half of those being men.

If you are experiencing pain in your hip, knee or any other joint that impacts your daily activities, then you are not alone. Join the 30,000 people who have already found relief from their pain with Orthopedic Centers of America. Call 1-888-549-0835 to speak with a patient coordinator who can direct you to an orthopedic specialist with the experience you can trust. The call is free and is the next best step you can take towards finding pain relief.

Symptoms of Avascular Necrosis

Interestingly, most cases of hip avascular necrosis are bilateral, which means that they occur in both hips. Small bones have been known to be affected with avascular necrosis, but usually the rounded end of the long leg bone is the most common bone to deteriorate due to a lack of blood supply. Symptoms are different for everyone, but they generally include noticeable pain that soon becomes regular. Once the pain becomes constant and you have difficulty putting weight on your leg, then the avascular necrosis has progressed significantly. The period from the first instance of pain and the loss of joint function can be between 6 – 12 months or longer, depending upon the patient, his age and use of the joint.


Causes and Risk Factors for Avascular Necrosis

Avascular necrosis is caused by a diminished supply or loss of circulatory blood inside the bone. This can happen from sudden trauma. If you experience an injury to the hip and later begin to walk with a limp due to pain, it is important to see a physician before the condition worsens. Avascular necrosis can happen inside any bone, and pain is the indication that help is needed. Without treatment, severe pain and limitations in movement will occur.

At Orthopedic Centers of America, we want to help you preserve your joints. We can direct you to a highly-skilled orthopedic specialist who has the skills and experience you can trust to diagnose your pain and address the underlying problem. Our physicians do not engage in prescribing narcotics for pain. Instead, they work to resolve the source of your pain for long lasting results. Call 1-888-549-0835 today to speak with a patient coordinator who can direct you to an orthopedic surgeon for your pain. It is a free call and will help you start on your journey towards relief from pain.

Other causes of avascular necrosis are:

  • steroid medicines – A common culprit of AVN are corticosteroids that may be prescribed for a patient’s inflammatory disease. The generally accepted thought is that corticosteriods build up in the bone and clog the blood vessels, causing the lack of blood supply to the bone.
  • excessive alcohol use – causes fatty substances to accumulate and block the blood supply to the bones.
  • chemotherapy
  • HIV infection
  • Gaucher’s disease
  • Caisson disease


Non-Surgical Treatment Options

Non-surgical treatment options are used to minimize pain and delay surgery, but they do not correct the cause of the disease. Suggested non-surgical treatments are:

  • Medications – over the counter NSAIDS (non-steroidal anti-inflammatory drugs) may relieve some pain. Additionally, cholesterol reducing medicines may be prescribed to lower the lipid build up in the bone.
  • Reduced activity – limited use of the painful joint may slow the damage and provide time for natural healing.
  • Range of motion exercises – a physical therapist can assign exercises to help you maintain range of motion without exacerbating the problem
  • Electrical stimulation – this treatment, in some cases, will cause bone growth.


Surgical Treatment of Avascular Necrosis

In most cases, surgery will be needed to correct avascular necrosis and to keep it for affecting other parts of the body. Usually more than one joint is affected when a patient presents with AVN.

The following are examples of surgical treatment options.

  • Core decompression – This is a surgical technique that is used in early stages of AVN where the surgeon removes an inner portion of the bone to increase the blood flow and relieve the pressure inside the bone. Often, this procedure reduces pain and slows the progression of the disease for those who are in early stages.
  • Osteotomy – This surgical procedure is best for patients in early stages of AVN and is the surgical process of reshaping the bone to make room for better blood flow. Recovery may last several months.
  • Bone Graft – In an effort to save the bone from AVN, a surgeon will use a portion of healthy bone from another part of the body as a graft to promote healing. This can take several months.
  • Arthoplasty/Total Joint Replacement – As a last measure, if AVN has progressed to the late stage, then a surgical joint replacement may be required to replace the bone with artificial parts that will not be affected by AVN.

Prevention and awareness of what is causing your pain are crucial for a patient experiencing the symptoms of avascular necrosis. If the bone has not completely died, then an experienced orthopedic specialist may discuss one of the surgeries listed above before a total joint replacement is attempted.



Avascular necrosis is a very serious health event which can progress quickly depending upon the age and activity level of the patient. Once surgery is completed, instructions will be given for a full rehabilitation regimen designed to increase range of motion, minimize pain and provide strength and flexibility needed. A safe exercise schedule will be suggested to you by the physical therapist.

Call 1-888-549-0835 today to speak to a patient coordinator who can direct you to an orthopedic specialist knowledgeable about avascular necrosis. At Orthopedic Centers of America, we want to help you find relief from your pain. Take the next step by making the free call. Life Awaits.








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