Avascular Necrosis

What is avascular necrosis, or osteonecrosis?

Avascular necrosis (AVN) is a bone disease also known as osteonecrosis (ON). It can happen when a bone is deprived of its normal blood supply, for example after an organ transplant, or long-term cortisone treatment. Without proper blood flow, sections of bone weaken, die and eventually collapse. This is especially true of the hip joint, as ON appears most commonly at the top end of the femur (the long bone that extends from the knee to the hip joint). ON causes the bone to degrade in the joint, which can cause arthritis1.

In recent years we have learned a lot more about ON and its potential causes, and research into the genetic links is ongoing. You are at higher risk of developing ON if you have dislocated or fractured a hip, suffer from alcoholism, use corticosteroids, or have a glandular disease like rheumatoid arthritis, Gaucher's disease, chronic pancreatitis, Crohn's disease or lupus2.

What are the symptoms of osteonecrosis?

Patients with early-stage ON may not experience or even notice any symptoms, but as the condition progresses, symptoms can include pain, reduced mobility and range of motion in the affected joint, and osteoarthritis. ON develops differently in each person it affects, and it can take from a few months to over a year from feeling the first pain symptoms pain to losing joint function3

How is osteonecrosis treated?

Avascular necrosis/osteonecrosis is treated in a similar way to osteoarthritis.

To diagnose you properly and offer the right treatment, your doctor will consider your symptoms and medical history, examine your joints, and arrange one or more diagnostic tests. For example, they may suggest blood tests, X-rays, a CT scan, or an MRI scan, to get a clear view of your joint alignment and general condition. They may focus on the condition of your femur and whether the head of the bone, which attaches to the hip, is still intact.

Based on the results of these tests, your doctor will then discuss the best treatment options with you. Depending on the severity of your ON, how much it affects your mobility and the pain you’re experiencing, treatments may include:

  • Pain relief – medication can help alleviate your pain, improve your joint mobility and function, and prevent any further damage.
  • Support and exercise – your doctor may recommend you try to reduce weight bearing on the affected joint. This might mean using a crutch, or limiting your activity so your joint can heal faster and more effectively while you're having treatment. He or she may also recommend some simple exercises, or even prescribe a course of physiotherapy,
  • A surgical procedure or joint replacement surgery, if your ON symptoms or pain levels are no longer controlled with other therapies.

Always discuss your treatment options with your doctor.

1. Arthritis Foundation website, http://www.arthritis.org/disease-center.php?disease_id=17, accessed November 2012
2. Arthritis Foundation website, http://www.arthritis.org/disease-center.php?disease_id=17&df=causes, accessed November 2012
3. Arthritis Foundation website, http://www.arthritis.org/disease-center.php?disease_id=17&df=effects, accessed November 2012

What causes hip pain?

What causes hip pain?

Hip pain is sometimes caused by deformity or injury, but one of the most common causes is osteoarthritis (OA), also known as degenerative joint disease (DJD). Although affected by things like age, weight, joint function and general activity levels, arthritis in the hip is basically the result of your hip’s cartilage lining wearing away slowly over time, and the bones beginning to rub against each other. This causes friction, swelling, pain, stiffness, and instability.

How does arthritis affect the hip?

Arthritis is one of the most common causes of joint disorders, and is the major cause of disability and chronic pain in Australia, affecting 3.85 million Australians1.  And as the average age rises, the number of people with arthritis is also growing. In fact, leading researcher Access Economics suggests 7 million Australians will suffer some form of arthritis by 2050, based on current trends2.

See how arthritis affects the hip in this video:

What can you do about hip pain?

There are many ways to help relieve your pain

The causes of hip pain include:

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Next Steps

Contact your GP or health professional to discuss your options