Avascular Necrosis of Hip

AVN can develop due to a variety of factors that interfere with blood circulation to the bone.

• Trauma: Hip fractures or dislocations may damage blood vessels.
• Steroid Use: Long-term or high-dose corticosteroid therapy increases risk.
• Alcohol Consumption: Excessive intake can lead to fatty deposits in blood vessels, restricting flow.
• Medical Conditions: Sickle cell disease, lupus, and clotting disorders are linked with AVN.
• Idiopathic: In some cases, the exact cause remains unknown.

Patients may experience gradual onset of pain and restricted mobility.

• Dull or throbbing pain in the groin, thigh, or buttock
• Pain that worsens with activity and improves with rest
• Stiffness or reduced range of motion in the hip joint
• Limping or difficulty bearing weight on the affected leg
• Advanced stages may cause constant pain even at rest or night

Accurate diagnosis helps determine the stage and best treatment.

• X-rays: Reveal structural changes and bone collapse in later stages.
• MRI scans: Detect early bone changes before they appear on X-ray.
• CT scans: Provide detailed images of bone architecture.
• Bone scans: Show reduced blood flow and areas of damage.

Management depends on the stage of the disease and the extent of bone involvement.

Non-surgical Treatments:

• Medications to reduce pain and inflammation
• Restricted weight-bearing to slow progression
• Physiotherapy to maintain mobility and strength
• Bisphosphonates or anticoagulants in selected cases

Surgical Treatments:

• Core Decompression: Drilling into the femoral head to reduce pressure and stimulate new blood flow.
• Bone Grafting: Using healthy bone or stem cells to support regeneration.
• Hip Replacement: In advanced stages, total hip arthroplasty is performed to restore function.

The outcome depends on how early AVN is diagnosed and treated. Early intervention may slow or stop progression, while advanced cases often require joint replacement. Younger patients - early stage benefit from joint-preserving procedures, whereas advanced stage with extensive damage may achieve excellent results with hip replacement surgery.

Avascular necrosis of the hip is a progressive condition that can severely impact mobility and quality of life if left untreated. Recognizing symptoms early and seeking specialized orthopedic care allows timely intervention to preserve or restore joint health. With proper management—ranging from non-surgical therapies to advanced surgical techniques—patients can regain stability, reduce pain, and return to active living.