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AVN happens when a bone loses its blood supply. Without blood bringing essential nutrients, the tissue in the bone dies. And in time, the bone collapses.
Although AVN (also called osteonecrosis of the hip) can occur in the knees and shoulders, it's most common in the hip. It affects the femoral head (thigh bone) in one or both hips.
As the disease worsens, pain increases and range of motion decreases.
Doctors in the U.S. treat more than 20,000 people for AVN every year.
The disease is most common between the ages of 40 and 65.
More men than women get AVN.
Sometimes the cause of AVN is unknown. But doctors can often pinpoint the reason blood supply to a bone declines.
Reasons for reduced blood supply to a bone include:
The best way to prevent AVN is to lead a healthy, active lifestyle.
These changes can help keep your bones strong:
U.S. News and World Report ranks us as one of the best orthopaedic programs in the nation.
Here are just a few of the reasons why:
In the early stages, you may not notice any symptoms of AVN.
As the disease gets worse, you may notice:
If your hip pain is persistent or getting worse, you should see a doctor and find out if it's AVN.
There are 4 stages of AVN.
In Stage 1 of AVN, the hip is still healthy. By stage 4, the femoral head collapses and causes severe osteoarthritis.
The earlier doctors diagnose and treat AVN, the better the chances of a good recovery.
Your doctor will:
To confirm the diagnosis, the doctor will order imaging tests.
Those may include:
The doctors at UPMC are experts at treating AVN. Their goal is to restore function to the affected joint so you can continue to lead an active life.
Treatment for AVN will depend on:
Lifestyle changes and medicine will not cure AVN. But they can relieve pain and delay the need for surgery. In the later stages of the disease, surgery is almost always necessary.
In the early stages of AVN, lifestyle changes and physical treatments may slow the progression of the disease and allow some healing.
Some treatments that may help include:
Certain medications can relieve pain and help manage the disease. Doctors may prescribe them along with lifestyle changes.
Many people will eventually need surgery for AVN. The type of operation depends on the progression of the disease.
Your doctor will decide the method that's best for you.
Core decompression is a form of surgery that relieves pressure in the bone. It may be a good option if your AVN is in the early stages. It won't work if the bone has already collapsed.
During core decompression surgery, doctors drill a hole in the core of the affected bone. This reduces pressure and creates channels for new blood vessels. Blood circulation in the hip improves and the bones become healthier.
It takes about 3 months to fully heal.
This surgery reshapes the bone to reduce stress on the joint. Doctors use it when you have a small area of affected bone.
Recovery takes anywhere from 3 to 12 months.
A bone graft is when your doctor takes healthy bone from you or a donor and inserts it into the diseased bone. This procedure, known as osteochondral (bone and cartilage) grafting, helps regenerate healthy bone and support cartilage at the hip joint.
Another type of bone grafting is the vascularized fibular graft.
Doctors take a piece of healthy bone from the small leg bone (fibula) along with the artery and vein. They transplant and attach it to the hip so that healthy bone can grow.
Recovery from bone grafting takes a few months.
If you have Stage 3 or 4 AVN (collapsed), your doctor will likely perform a hip replacement. This procedure replaces the damaged bone with artificial parts.
It takes about 8 weeks to heal after hip replacement surgery.