Avascular necrosis; Osteonecrosis; Ischemic bone necrosis; AVN; Aseptic necrosis

If your health care provider knows the reason for osteonecrosis, part of the treatment will be aimed at the underlying condition. For example, if a blood clotting disorder is the reason, treatment will consist, in part, of clot-dissolving medicine.

If the condition is caught very early, you will take pain relievers and limit use of the affected area. This may include using crutches if your hip, knee, or ankle is affected. You may need to do range-of-motion exercises. Nonsurgical treatment can often slow the progression of osteonecrosis, but most people will need surgery.

Surgical options include:

• A bone graft
• A bone graft along with its blood supply (vascularized bone graft)
• Cutting the bone and changing its alignment to relieve stress on the bone or joint (osteotomy)
• Total joint replacement
• Removing part of the inside of the bone (core decompression) to relieve pressure and allow new blood vessels to form

You can find more information and support resources at the following organizations:

• National Osteonecrosis Foundation -- www.nonf.org
• ON/AVN Support Group Int’l Association --http://osteonecrosisavnsupport.org
• The Arthritis Foundation -- www.arthritis.org
• Center for Osteonecrosis Research and Education (CORE) -- http://www.osteonecrosis.org

Prognosis depends on the following:

• Stage of the disease when it was diagnosed
• Size of the area of bone involved
• Whether any other conditions were involved
• Age and general health of the person affected

The outcome can vary from complete healing to permanent damage in the affected bone.

Advanced osteonecrosis can lead to osteoarthritis and permanent decreased mobility. Severe cases may require joint replacement.

Images

Aseptic necrosis

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Osteonecrosis Symptoms

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Osteonecrosis Prevention

Review Date: 07/10/2009
Reviewed By: Linda J. Vorvick, MD, Medical Director, MEDEX Northwest Division of Physician Assistant Studies, University of Washington, School of Medicine; and C. Benjamin Ma, MD, Assistant Professor, Chief, Sports Medicine and Shoulder Service, UCSF Dept of Orthopaedic Surgery. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org)