Hip avascular necrosis

Person with hip injury

​​​​​​​Avascular necrosis (AVN) is when blood supply is cut off and the bone tissue dies. If avascular necrosis happens near a joint, the joint surface may collapse. Also known as osteonecrosis, avascular necrosis most frequently occurs in the hip and shoulder; however, it can also affect other major joints such as the wrist, knee, elbow and/or ankle.

Hip avascular necrosis can happen without any known cause. It also occurs as a result of disease or a severe trauma, including a hip fracture or hip dislocation.

Other causes are:

  • Blood vessel damage

  • Chemotherapy

  • Long-term use of medicines, such as corticosteroids

  • Excessive use of alcohol

  • Radiation

  • Some specific chronic conditions

Hip avascular necrosis symptoms 

Symptoms of avascular necrosis include: 

  • Limp while walking

  • Limited range of motions in the hip

  • Pain that gradually increases in intensity 

  • Pain while putting weight on the hip and when lying down

  • Stiffness in the hip 

Hip avascular necrosis diagnosis 

The symptoms of avascular necrosis sometimes look like other medical conditions, so see your doctor for a diagnosis. Leaving avascular necrosis untreated can deteriorate the hip joint and cause arthritis

One of the following tests is used to diagnose avascular necrosis: 

  • X-ray—a diagnostic test that provides images of the bones and tissue of the hip.

  • Computed tomography scan (also called a CT or CAT scan)—uses X-rays and a computer to make detailed images of the bones, muscles and tissue around the hip joint. 

  • Magnetic resonance imaging (MRI)—a diagnostic test that provides detailed images of the hip joint. 

  • Radionuclide bone scan—a nuclear imaging technique that injects a small amount of radioactive material into the blood to examine blood flow to the hip bo

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Hip avascular necrosis treatment 

Treatment for avascular necrosis is determined by first identifying the underlying cause of the condition. 

If caught early, the following treatment options can be effective: 

  • Medications—for pain relief

  • Assisted devices—such as a cane, crutches or walker to protect the hip joint and control pain.

  • Surgery—if avascular necrosis is severe, surgical intervention may be: 

  • Core decompression—removes a portion of the affected bone’s inner layer.

  • Bone transplant (graft)—takes a section of healthy bone from a different part of the body and implants it to strengthen the area of hip bone. 

  • Bone reshaping (osteotomy)—shifts the weight off the affected bone by removing a bone wedge above or below the affected joint. Often this option is used to postpone a joint replacement. 

  • Joint replacement—a surgical procedure that replaces the damaged joint with plastic and metal parts. 

If you have the symptoms of avascular necrosis, see one of our orthopedic specialists at The Christ Hospital Health Network for diagnosis and treatment.

Find a hip specialist near you.