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How is avascular necrosis treated?

The treatment options depend on how early the condition is diagnosed - early intervention can avoid the need for surgery or joint replacement. Current treatment options include: exercise, hyperbaric oxygen therapy and electrical stimulation - to encourage regeneration; medication to ease symptoms and complications; bed rest and use of crutches to rest the joint; bone core decompression - to ease pressure, relieve pain and encourage bone regeneration; bone graft - to encourage regeneration of bone, and; total joint replacement - to repair bone that has collapsed and to avoid disability.

FAQ Frequently asked questions

What is avascular necrosis?

Avascular necrosis is the name given to bone death, a condition that occurs when the blood supply to an area of bone is cut off, either temporarily or permanently.

What are the symptoms of avascular necrosis?

The most common symptom of avascular necrosis is pain in the hips, inner knee and thighs, especially when being active. Limping and pain in the groin while walking are also commonly reported.

What causes avascular necrosis?

Bones are living tissues, which are fed by blood vessels. Bone that is avascular (without blood) for long cannot survive, becomes brittle and eventually collapses, causing severe arthritis and dysfunction in the affected joint.

Who gets avascular necrosis?

Most people with avascular necrosis are first diagnosed with the condition between the ages of 30-50. There is a rare form of this condition, Perthes' disease, which affects children aged between 3-11 and tends to target the head of the femur.

How is avascular necrosis diagnosed?

Magnetic resonance imaging (MRI) can detect changes in the density and structure of bones. MRI is considered the best option for diagnosing avascular necrosis, as it can pick up on chemical changes in the bone marrow before any symptoms are felt.

Can avascular necrosis be cured?

There is no cure for avascular necrosis, but early diagnosis and intervention may help to avoid bone collapse and the need for bone grafts or joint replacement.

Can avascular necrosis be prevented?

Many cases of avascular necrosis cannot be prevented, as often the cause is unknown, but there are some recommendations to lower the risk: if at all possible, avoid high doses or long-term use of corticosteroids; avoid excessive alcohol consumption, …

Is avascular necrosis serious?

Yes. Left untreated, many cases of avascular necrosis will lead to bone degeneration, bone collapse and disability. Range of movement within the nearby joint can be greatly reduced and debilitating arthritis is a common outcome.

What increases the chances of developing avascular necrosis?

A person's chances of developing avascular necrosis are increased by chronic alcohol consumption, deep-sea diving, long-term or high-dosage steroid use, previous bone fractures or dislocation and a number of other health …

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About this article

Author: Dr Idan Ben-Barak PhD, MSc, BSc (Med)
First answered: 10 Jul 2015
Last reviewed: 19 May 2018
Rating: 4.2 out of 5
Votes: 260 (Click smiley face below to rate)
Category: Perthes disease

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