What are the Main Treatment Options for Hip Avascular Necrosis?

Hip AVN Treatment Guide: Medications, Surgery and Preventive Care

Hip avascular necrosis, or AVN, refers to the loss of bone tissue due to poor blood supply. It usually affects the end part of long bones, causing them to crumble by forming small cracks. They can affect not only long bones but also any bones in your body. Under this condition, a fractured joint or cracked bone can disrupt the blood flow of a particular portion of the bone.  

 
AVN is also called osteonecrosis, and it mostly affects those between the ages of 30 and 50 years. Individuals taking high-dose steroid medicines for a long time and consuming excessive alcohol are more likely to develop conditions like hip avascular necrosis.  

 
Keep reading to learn about its treatment procedure, causes, symptoms, and diagnosis procedure! 

How to Treat Hip Avascular Necrosis? 

 
The treatment procedure for hip avascular necrosis depends completely on the patient's health condition, age, symptoms, femoral head condition, etc. Here are some of the effective treatment methods for hip AVN: 

1. Non-surgical Treatment 

 
Individuals in the early stage of avascular necrosis can follow non-surgical treatment. It may help relieve symptoms and may slow progression in early-stage AVN, but they generally do not reverse established bone damage. Some of the non-surgical treatments are as follows: 

• NSAIDs(nonsteroidal anti-inflammatory drugs) for pain relief 
• Physical therapy to strengthen hip muscles 
• Using crutches, canes, and walkers so that the excessive weight is not put upon the injured hip 
• Proper rest 

2. HBO (Hyperbaric oxygen) Therapy 

 
It is another non-surgical therapy that helps tackle the early signs of AVN. It is a safe and effective therapy session that lasts for 90 minutes. An individual needs a minimum of 30 sessions, with five sessions per week.  

3. Bone Grafting 

 
In this procedure, healthy bone tissue is collected from the patient’s body to replace the damaged bone. It can also be done using artificial bone substitutes. 

4. Osteotomy 

 
In this method, the surgeon cuts and repositions the femur to transfer the patient's weight to the healthy area of bone that can bear weight. 

5. Core Decompression 

 
It is a minimally invasive procedure in which the AVN-affected femoral head is drilled to improve blood flow, reduce the pressure inside your bone, and restore hip joint function. 

6. Total Hip Replacement 

 
In case of extreme damage to the femoral head, acetabulum, and hip joint, the patient must undergo a total replacement of their hip. 

7. Surgical Intervention 

 
Surgical treatment can reduce pain, improve function, and slow disease progression, particularly when performed before femoral head collapse. 

How to Prevent Hip Avascular Necrosis? 

While not all cases of hip avascular necrosis are preventable, primarily those caused by genetic conditions, autoimmune diseases, or other necessary medical treatments. However, early detection and management can help slow progression. 

The following are some preventive measures: 

• Limit alcohol consumption. 
• Quit smoking if you smoke. 
• Maintain healthy cholesterol levels. 
• Monitor steroid use carefully. 
• Maintain a healthy lifestyle. 
• Eat a balanced nutrient-rich diet 
• Protect your joints from injury.  

What Causes Hip Avascular Necrosis? 

 
When bone tissues become inactive due to interrupted blood supply to the femoral head, it causes hip avascular necrosis. Its types and causes are discussed below: 

1. Nontraumatic Hip AVN  

 
Excessive intake of alcohol and long-term use of corticosteroids causes almost 80% of nontraumatic AVN.  

2. Traumatic Hip AVN 

 
If the blood flow to your femoral head stops due to trauma, it can cause traumatic hip AVN. It may occur after hip dislocation, fracture, or previous surgery. 

 
Here are some more factors that cause hip avascular necrosis: 

• SLE(systemic lupus erythematosus) 
• Smoking 
• Previous history of chemotherapy or radiation therapy 
• Sickle cell disease 
• Decompression sickness 
• Pancreatitis 
• Gaucher disease 
• Chronic liver disease 
• HIV infection 
• Excessively high lipid levels in blood (hyperlipidemia) 
• Thrombophilia or other blood clotting disorders 
• Gout 

 
Note: In most cases, the cause of hip AVN remains unknown. 

What are the Symptoms of Hip Avascular Necrosis? 

 
Avascular necrosis (AVN) of the hip usually starts with minor symptoms before getting worse over time. Here are some of the common symptoms: 

• Hip Pain: It is the first and most typical symptom that causes a throbbing ache in the buttocks or groin. As AVN worsens, it gets harder to stand or bear weight on the afflicted side because hip movement becomes more uncomfortable. Early stages may even be symptom-free, and progression times range from a few months to more than a year. 
• Stiffness: As the illness worsens, stiffness and a decreased range of motion may accompany the pain, which may become constant and limit day-to-day activities.  
• Deformity: Deformity and trouble walking may result from swelling and joint instability, particularly if the bone collapses. When moving the joint, some people get crepitus, which is a grating or cracking sensation. Since timely treatment can enhance results and slow the progression of the disease, early detection is essential. 

How to Diagnose Hip Avascular Necrosis? 

 
Here are the diagnostic procedures for avascular necrosis of the hip: 

Physical Test 

 
During a physical exam for avascular necrosis, a healthcare provider checks for tenderness by pressing around the joints and moving them through various positions to assess any loss of motion.  

Imaging Test 

 
As joint pain may occur for several reasons, imaging tests are used to identify avascular necrosis specifically. X-rays may show bone changes in later stages but often appear normal during the early stage of the disorder.  

 
MRI and CT scans provide more detailed images and can detect early bone changes before they are visible on X-rays. A bone scan involves injecting a small amount of radioactive material, which highlights injured or healing bone areas as bright spots on the scan. 
Recovery or symptom control in hip avascular necrosis depends on the stage of disease. Early-stage AVN may be managed with non‑surgical measures or joint‑preserving procedures, while advanced disease often requires surgical intervention. Considering the complexity of AVN, the cost of surgery may be high. 

Reader Information: The information provided in this article is intended for general educational and informational purposes only and should not be considered a substitute for professional medical advice, diagnosis, or treatment. Hip avascular necrosis (AVN) is a complex condition, and its diagnosis and management vary based on individual health factors, disease stage, and clinical findings. Always consult a qualified healthcare professional or orthopedic specialist for personalized medical evaluation, treatment recommendations, and follow‑up care.

Also Read:

→ Avascular Necrosis and Its Impact on Bone Health

→ What are the 4 Stages of Avascular Necrosis