Avascular Necrosis Treatment

When part of your bone tissue does not have enough blood supply, it can lead to the death of the bone. This condition is called avascular necrosis (also called osteonecrosis). It’s most common in men under the age of 50. While it can happen in any bone, the most common places are the shoulders or the ends of the thigh bones.

What causes avascular necrosis?

The flow of blood may be restricted because of blood vessel damage, a blockage in the vessels, or inflammation in the vessel walls. The most common cause of avascular necrosis is an injury to the bone. However, other factors may put you more at risk, such as:

• Excessive alcohol use
• Corticosteroid use
• Chemotherapy
• Radiation therapy
• Organ transplant

What are the symptoms of avascular necrosis?

At first, you may have no symptoms at all. As the condition becomes worse, you may have:

• Pain in the joint
• Stiffness
• Worsening pain after activity or at night
• Restricted motion in the joint

What are the treatment options for avascular necrosis?

To properly diagnose and treat your condition, your doctor may order imaging tests, like MRI, CT scans, bone scans, or X-rays. From there, your doctor will create a customized treatment plan for you. Most likely, you’ll begin with non-surgical options.

Non-surgical treatment options may include:

• Medications, such as pain relievers, blood thinners, or cholesterol-lowering drugs
• Exercise program
• Activity restrictions
• Crutches

If these options fail to treat your avascular necrosis, then surgery may be offered. Surgical treatments include:

• Osteotomy
  This surgery is recommended for early-stage disease when only a part of the bone is affected. During surgery, stress on the bone is reduced by reshaping it.
• Core decompression
  This is typically used for early-stage avascular necrosis. The surgery removes the inner core of the bone to increase blood flow.
• Bone grafting
  A bone graft is healthy bone, either from your body or from a donor. It is placed into the affected bone after core decompression.
• Total joint replacement (arthroplasty)
  This procedure replaces part of the joint with artificial pieces. It is usually done for avascular necrosis that is advanced or extensive.