What is Avascular Necrosis of the hip?

 ​Avascular necrosis is a localized death of bone as a result of local injury (trauma), drug side effects, or disease. This is a serious condition because the dead areas of bone do not function normally, are weakened, and can collapse. Avascular necrosis ultimately leads to destruction of the joint adjacent to the involved bone. The hip is the most common joint affected by avascular necrosis, followed by the knee, shoulder, ankle, elbow, and wrist.   ​...........................................................................

 

What does Avascular Necrosis cause?​
 While the precise mechanism for the development of avascular necrosis is not known, it is suspected that interruption of the blood supply to the affected bone plays some role. This can occur when traumatic impact injures the blood vessels to the bone or when diseases produce areas of abnormal circulation.  There are many causes of avascular necrosis, but the vast majority of avascular necrosis is caused by either traumatic injury to the affected bone (such as fracture and dislocation), steroid medication usage (glucocorticoid medications such as prednisone and prednisolone, particularly when given in high doses), or excessive alcohol consumption.  

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Avascular Necrosis Symptoms

Aseptic necrosis begins as a painless bone abnormality. It can remain painless. The involved bone often later develops pain, especially with use. Pain in the affected joint is usually the first symptom of avascular necrosis. When the lower extremity is affected, this can lead to a limp during walking. If the hip is affected, groin pain is common, especially when walking. As the ball of the hip collapses with progression of avascular necrosis of the hip, pain can persist in the hip after rotation or weight-bearing with walking.
 

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​Avascular Necrosis Treatment
The surgical management of avascular necrosis can be divided into joint-preserving procedures and joint-replacement (arthroplasty) procedures. Joint-preservation operations that delay the need for total joint replacement include measures that allow improved blood supply to the affected bone. These procedures are typically used in early avascular necrosis of the hip and include removal of a core of bone from the head of the femur bone of the hip (core decompression) as well as local bone-grafting procedures. Sometimes bone-resurfacing procedures are used in an attempt to further delay joint-replacement surgery. When avascular necrosis has progressed to a significant stage and bone has collapsed, joint-replacement surgery is ultimately required.