Avascular necrosis (osteonecrosis) is a disease where there is cellular death (necrosis) of bone components due to interruption of the blood supply. Without blood, the bone tissue dies and the bone collapses. If avascular necrosis involves the bones of a joint, it often leads to destruction of the joint articular surfaces.
The blood flow to a section of bone can be interrupted if the bone is fractured or the joint becomes dislocated. Avascular necrosis of bone is also associated with long-term use of high-dose steroid medications and excessive alcohol intake. The hip is the joint most commonly affected by avascular necrosis.
Because most people don’t start having symptoms until the disease is fairly advanced, you may need to consider surgeries such as:
- Core decompression: In this operation, your surgeon removes part of the inner layer of your bone. In addition to reducing your pain, the extra space within your bone stimulates the production of healthy bone tissue and new blood vessels.
- Bone transplant (graft) This procedure can help strengthen the area of bone affected by avascular necrosis. The graft is a section of healthy bone taken from another part of your body.
- Bone reshaping (osteotomy)This procedure removes a wedge of bone above or below a weight-bearing joint to help shift your weight off the damaged bone. Bone reshaping may allow you to postpone joint replacement.
- Joint replacement If your diseased bone has already collapsed or other treatment options aren’t helping, you may need surgery to replace the damaged parts of your joint with plastic or metal parts.