Avascular Necrosis Treatment
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:
- The stage of the disease.
- Your age.
- Overall health.
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.
Non-medical treatments for AVN
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:
- Crutches, to limit the amount of weight you put on the joint.
- Rest.
- Physical therapy.
- Electrical stimulation, which can help your body produce new bone.
Medical treatments for AVN
Certain medications can relieve pain and help manage the disease. Doctors may prescribe them along with lifestyle changes.
- Anti-inflammatory drugs.
- Blood thinners to prevent clots.
- Cholesterol-lowering drugs, to keep fat from blocking the blood supply to the bones.
Surgery to treat AVN
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
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.
Osteotomy
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.
Bone grafting
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.
Total hip replacement
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.