Avascular Necrosis

When the death of bone tissue occurs, it’s known as avascular necrosis. This type of condition causes joint pain gradually and could lead to the collapse of the bone or limited mobility.

When avascular necrosis occurs, you may need surgery. Dr. John Andrachuk specializes in treatment options for many types of joint and bone injuries with years of experience. Whether the avascular necrosis was caused by trauma or a disease, the right Orthopedic Sports Medicine surgeon in Atlanta makes a big difference.

What is Avascular Necrosis?

Also referred to as bone infarction or osteonecrosis, avascular necrosis is the death of bone tissue. It happens when someone experiences a loss of blood to the area of the body. Without treatment avascular necrosis may cause the bone to collapse.

It’s most commonly found in the hip, but can also be found in the shoulders, ankles, and knees.

What are the Causes of Avascular Necrosis?

Avascular necrosis can be caused by a number of things, but most commonly, it’s a result of joint dislocations, bone fractures, high-dose steroids, or alcoholism. 

Along with these common causes of avascular necrosis, it can also be caused by:

• Cancer treatments
• Fatty deposits found in the blood vessels
• Sickle cell anemia
• Gaucher’s disease
• Caisson disease
• HIV infection
• Lupus
• Prolonged exposure or repeated exposure to high pressures

About one-quarter of those diagnosed with avascular necrosis, the cause is unknown.

Most Common Risk Factors for Avascular Necrosis

Some of the most common risk factors for developing avascular necrosis include:

• Excessive alcohol use – If you consume several drinks daily, you are in a higher risk group for avascular necrosis. Overconsumption of alcohol over several years may cause fatty deposits to form within your blood vessels.
• Steroid Use – If you’ve used high-dose corticosteroids, you are at risk of developing avascular necrosis. 
• Trauma – Injuries, especially to the hip may put you at a higher risk of developing avascular necrosis. Hip fracture or dislocation is a common risk factor.
• Medical treatments – Some medical treatments, such as organ replantation or radiation therapy can weaken the bones.
• Bisphosphonate use – Using bisphosphonate over time may contribute to developing avascular necrosis of the jaw. While it’s rare, it can put you in a higher risk group.

Avascular Necrosis Symptoms

One of the scariest things about avascular necrosis is the fact that many patients don’t experience any symptoms in the early stages. However, as the condition gets worse, the joint affected by avascular necrosis may begin to hurt. The pain can even continue when lying down. 

At first, the pain you experience might be mild and develop over time. If you suffer from avascular necrosis of the hip, you might experience pain in the buttock, thigh, or groin. 

Avascular Necrosis Diagnosis

A physical exam is the first thing your doctor will likely perform when diagnosing avascular necrosis. Your doctor will look for tender spots by pressing on your joints and moving your joints through a series of positions.

Along with a physical exam, your doctor will likely order the following:

• A Bone Scan – You will receive an injection of radioactive material to the injured area and it will show up on the image.
• An MRI and CT Scan – This type of scan helps the doctor see changes in the bone.
• X-Rays – If your avascular necrosis is past the early stages, X-Rays can be used to diagnose the condition.

How Fast Does Avascular Necrosis Progress?

The speed avascular necrosis will progress at depends on the cause and how much you’re exposed to the causation factor. It can be slowed down by avoiding the causation factor. For example, if your avascular necrosis was caused by alcohol or steroids, eliminating the use of the substance can slow the progression.

Avascular Necrosis Treatment

Several treatment options are available including avascular necrosis treatment without surgery. Your doctor may prescribe medication during the earlier stages of this condition, such as:

• Nonsteroidal anti-inflammatory drugs (NSAIDs)
• Blood thinners
• Cholesterol-lowering drugs
• Osteoporosis drugs

Along with medication, it’s common for a doctor to recommend rest and even certain types of exercise. Electrical stimulation may also be used to help grow new bone in place of the damaged bone.

Not all forms of avascular necrosis will be treated with medication and rest, however. As the condition progresses, you may need surgery or another treatment option. Common treatments for avascular necrosis include:

• Bone transplant – Also known as a bone graft, this procedure will help to add strength to the affected area. The graft will be a section of healthy bone taken from another area of your body used within the area affected by avascular necrosis.
• Joint Replacement – Replacing the joint with plastic or metal parts is usually considered if the diseased bone has collapsed or other treatments aren’t working. This type of avascular necrosis surgery can relieve the pain and get you back to a normal life.
• Core Decompression – Sometimes, a surgeon can remove a portion of the inner layer of the bone to treat avascular necrosis. Core decompression can help to relieve pain and allow for the production of healthy bone tissues and new blood vessels.
• Bone Reshaping – Also referred to as osteotomy, bone reshaping involved removing a wedge of bone below or above a weight-bearing joint. This procedure will help to shift the weight from the damaged bone and can be used to postpone joint replacement.
• Regenerative Medicine Treatment – A newer procedure involving a bone marrow aspirate and concentration, regenerative medicine treatment can be used in the early stages of avascular necrosis of the hip. It’s performed with stem cells from your bone marrow and removing a core of the dead hipbone. The stem cells are put into the place of the removed bone to help stimulate new bone growth.

Schedule an Appointment Today!

With extensive experience treating avascular necrosis, Dr. Andrachuk offers a variety of treatment options. If you’ve been experienced prolonged pain in your hips or in another joint, it’s time to seek medical help. Dr. Andrachuk offers the latest treatment options with minimally invasive options to help ease your pain. Contact us today and schedule your in-person or telemedicine appointment!