AVASCULAR NECROSIS

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What is Avascular Necrosis?

Black and white 3D model of the pelvis and leg with the upper leg bone colored red.

Avascular necrosis (AVN), also called osteonecrosis, occurs when bone tissue dies due to a loss of blood supply. Without adequate circulation, bone cells weaken, tiny cracks form, and the bone may eventually collapse. This process often results in joint pain, stiffness, and a reduction in functional capacity.

Trauma—such as fractures or dislocations—is one of the most common causes. These injuries can interrupt the blood vessels that nourish bone tissue. Other contributing factors include long-term corticosteroid use, excessive alcohol consumption, and certain medical conditions that impair circulation.

Although AVN can affect anyone, it most often appears between the ages of 30 and 50. Detecting it early is critical; timely treatment can prevent severe joint degeneration and delay or eliminate the need for major surgery.

 

How Is Avascular Necrosis Diagnosed?

During a physical exam, your orthopedic specialist will assess pain, joint tenderness, and range of motion. If AVN is suspected, imaging studies confirm the diagnosis and determine the stage of bone damage:

  • X-rays reveal structural changes or bone collapse in later stages of the condition.

  • MRI scans are the most sensitive test, detecting AVN early—before visible changes appear on X-rays—by showing reduced blood flow to the bone.

  • CT scans provide detailed cross-sectional images that help evaluate the integrity of the bone and aid in planning surgical procedures.

  • Bone scans highlight areas of decreased bone activity when the diagnosis remains unclear.

These diagnostic tools enable early detection, allowing your care team to initiate treatment before the bone collapses or the joint deteriorates.

 

Avascular Necrosis Treatment

The primary goal of AVN treatment is to restore blood flow, preserve bone structure, and protect the joint from further damage. Your treatment plan depends on the stage of the condition, your age, and overall health.

 

Non-Surgical Options

Early-stage AVN often responds well to conservative care.

  • Medications such as nonsteroidal anti-inflammatory drugs (NSAIDs) help relieve pain and reduce inflammation.

  • Bisphosphonates may be prescribed to slow bone loss and reinforce weakened areas.

  • Restricted weight-bearing using crutches or a brace reduces stress on the affected bone while it heals.

  • Physical therapy focuses on maintaining mobility and strengthening surrounding muscles to support the joint.
    Lifestyle changes, including reducing alcohol intake, quitting smoking, and maintaining a healthy body weight, also help preserve bone health.

 

Surgical Options

If non-surgical methods fail or bone damage progresses, surgery can improve blood supply and restore joint function:

  • Core decompression involves removing a small cylinder of inner bone to relieve pressure and stimulate the growth of new blood vessels.

  • Bone grafting replaces diseased bone with healthy donor or synthetic material.

  • Vascularized bone grafting utilizes a graft with its own blood supply to facilitate enhanced healing.

  • In advanced cases, joint replacement surgery may be recommended to restore joint function and alleviate chronic pain.

Your orthopedic surgeon will discuss the best approach for your stage of AVN and personal activity goals.

 

Avascular Necrosis Recovery

Recovery from AVN is gradual and depends on the severity of the disease and the type of treatment performed. Following surgery or conservative care, patients often begin with a protected weight-bearing phase to prevent further collapse.

Physical therapy continues to play a vital role, focusing on range-of-motion and strengthening exercises that improve joint stability and function. Your therapist will adjust activity intensity as healing progresses to prevent re-injury.

Pain management remains an essential aspect of recovery. Short-term use of NSAIDs and other prescribed medications helps minimize discomfort while encouraging mobility.

Regular follow-up appointments and imaging studies enable your orthopedic specialist to monitor your healing and ensure proper bone recovery closely. Most patients regain significant comfort and function within a few months when they adhere to their rehabilitation plan.

 

When to Seek Medical Attention

If you experience persistent joint pain, stiffness, or limited movement—especially after an injury or while using long-term steroids—contact Texas Orthopedic & Spine Associates for an evaluation. Prompt diagnosis and treatment can prevent irreversible bone loss and preserve joint health.

If you would like to speak with a Precision Orthopedic Specialist in the North Texas Area, please call us at 817-697-4038 or contact us online. Telemedicine appointments are also available.