Avascular necrosis is also called as Osteonecrosis. Avascular necrosis is a disease resulting from the temporary or permanent loss of the blood supply to the bones. Without blood, the bone tissue dies and causes the bone to collapse. If the process involves the bones near a joint, it often leads to collapse of the joint surface.
Conditions commonly associated with osteonecrosis are serious trauma which interrupts the bone's blood supply, extended and/or high doses of corticosteroid medications (such as prednisone and Solu-Medrol or methylprednisolone), and excessive alcohol consumption.
Patients may present with hip pain or (referred) knee pain. Physical examination will disclose that internal rotation of the hip - not movement of the knee - is painful.
Initially, plain X-rays are often normal. An MRI (Magnetic Resonance Imaging), CT (Computed Tomography) scan, and bone scan are all more sensitive techniques.
o Treatment starts with pain medications and limiting weight-bearing on affected areas. This type of conservative therapy may work well for patients with early osteonecrosis in small areas of bone. However, it does not work for those with hip or knee osteonecrosis who are facing progressive bone collapse.
o A procedure called core decompression may be used to remove a piece (core) of bone from the affected area in an attempt to improve blood flow.
o Bone grafting: During this procedure, your surgeon takes healthy bone from another part of your body and implants it into the area affected by a vascular necrosis.
o Joint replacement surgery replaces your joint with an artificial one.
o Bone reshaping: This procedure reshapes the bone to reduce the amount of stressed placed on the area affected by a vascular necrosis.
Avascular necrosis usually affects people between 30 and 50 years of age; about 10,000 to 20,000 people develop avascular necrosis each year.
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