Avascular Necrosis

Anatomy

The hip joint is the junction between the femur (thigh) bone and the pelvis and is referred to as a ball and socket joint. The head of the femur is the ball, and the socket is referred to as the acetabulum of the pelvis. Articular cartilage covers the femoral head and acetabulum allowing the bone to glide easily with one another. 

What is Avascular Necrosis?

Avascular necrosis (AVN), or osteonecrosis, is a condition in which there is inadequate blood supply to bone resulting in bone death. This can sometimes lead to collapse of the femoral head. There are many causes of AVN including trauma, high dose steroid use for prolonged periods of time, high alcohol consumption, sickle cell disease, autoimmune disorders, or hypercoagulable states. 

Symptoms of Avascular Necrosis

• Pain in the front part of the hip (groin)
• Stiffness
• Reduced hip motion
• Pain with activity

Diagnosing Hip Avascular Necrosis

A thorough patient history and physical exam along with  imaging studies including x-rays and MRI are often needed to confirm the diagnosis of avascular necrosis. 

Treatment for Avascular Necrosis

• Activity modifications and rest
• Medications including anti-inflammatories and bisphosphonates 
• Physical therapy
• Injections

• Core decompression: For younger patients without collapse of the femoral head. Helps to decompress the area of dead bone and restore blood flow to the area allowing for new bone growth
• Total hip replacement