Avascular Necrosis: What Is It and What Are the Treatment Options?

Osteonecrosis, commonly referred to as avascular necrosis (AVN), affects around 20,000 Americans every year. This condition, which targets the hips most often, results when something blocks blood flow to your bone tissue, causing it to die.

While AVN has different causes, for about 20% of people who dislocate or injure their hip joint, this serious condition follows. When not treated, AVN can cause the affected bone to collapse, reducing your mobility permanently. 

At his private practice in Houston, Texas, board-certified orthopedic surgeon Kwan (Kevin) Jun Park, MD, diagnoses and treats AVN to stop bone damage, preserve or improve your joint, and ease your pain. 

Here’s a closer look at AVN and the different treatment options available to help. 

What is avascular necrosis?

It’s easy to think of your bones as solid, unchanging structures once you reach adulthood, but your bones grow constantly throughout your life. 

During a process called remodeling, your old bone cells die and get replaced with new ones. This process keeps your bones healthy and strong.

When something blocks blood from reaching your bone tissue, your skeletal system doesn’t get the oxygen and nutrients needed to regenerate bone cells. As a result, the affected bone begins to die. Eventually, it crumbles and collapses. 

Although AVN most commonly affects the area of the hip where the femoral head attaches to the joint, other bones can be affected, including:

• Upper arms (humerus)
• Shoulders
• Jaw
• Knees
• Ankles

The most commonly affected people are those who experience a hip dislocation or injury, but other causes include fractures, long-term use of corticosteroids, certain health conditions (e.g., pancreatitis), smoking, alcohol use, and certain conditions that affect your blood and blood vessels (e.g., sickle cell anemia). 

How can I tell if I have AVN?

Avascular necrosis doesn’t start out with significant symptoms, so it can be tricky to know if you have AVN. In fact, it takes weeks or even months after an injury to notice any symptoms, which may include:

• Pain that comes when you press on the bone then goes away
• Joint pain and stiffness that gets progressively worse
• Increasingly limited range of motion
• Increasing trouble walking, standing, climbing stairs
• Limping that gets worse 

It’s important to get an evaluation with a bone specialist since AVN shares these symptoms with other conditions, like arthritis. Dr. Park reviews your medical history, performs a physical exam, and generally orders one or more tests to check for AVN, including:

• Radionuclide bone scan
• MRI, CT scan, X-ray, or other imaging study
• Bone biopsy

Dr. Park may also order other tests to rule out conditions that share symptoms with AVN.

What is the treatment for AVN?

Treatment for AVN depends on how damaged your bones are and other factors, including your condition, your age and overall health, and your symptoms. 

Using the above information, Dr. Park creates a personalized AVN treatment plan to improve the health of the affected joint and stop more bone damage from occurring. 

Some patients with damage only to small, non-weight-bearing bones may benefit from less invasive therapies, like ice and/or heat packs, rest, physical therapy, and pain medication. But most AVN patients require surgical intervention. 

As an experienced orthopedic surgeon, Dr. Park frequently treats AVN using hip replacement surgery. This surgery removes the diseased bone and damaged joint and replaces it with a biocompatible prosthetic. 

A total hip replacement allows you to move freely again — without pain — while preserving the health of your remaining bones and tissues.

If you’re worried about avascular necrosis or want to learn more about total hip replacements, schedule an appointment today with Dr. Park in Houston, Texas.