Osteonecrosis | Orthopaedics and Sports Medicine | Dartmouth-Hitchcock
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Osteonecrosis

Alternative names: Avascular necrosis, AVN

What is osteonecrosis?

The blood vessels that supply blood to the bones may gradually start to cut off this supply. Without enough blood flow to the bone, the bone will start to die and collapse. In a hip or knee joint, this causes pain and loss of movement. You may also develop arthritis. There is a good chance the same thing will happen to the other joint.

What are the signs of osteonecrosis?

A dull ache or throbbing in the groin area, buttocks, or knees may indicate you have osteonecrosis, especially if the following are also true:

  • Age 20-50 years
  • Previous dislocation or fracture
  • Alcoholism
  • Corticosteroid use
  • Any of the following glandular diseases: rheumatoid arthritis, sickle cell disease, Gaucher's disease, chronic pancreatitis, Crohn's disease, Caisson's disease, systemic lupus erythematosus

What causes osteonecrosis?

No one knows exactly what causes it, but it's estimated that doctors see 10,000-20,000 new cases per year.

How does my doctor tell if I have osteonecrosis?

A doctor will flex and rotate your joints to check to see if you have pain and if so, where the pain is. You may get an x-ray and possibly an MRI (magnetic resonance image) to see if the bone marrow is dying or dead, and how much of your joint has been damaged to the point of collapse.

How is osteonecrosis treated?

If you have osteonecrosis and your joint is still good, you may be able to have the dying bone taken out and a new bone graft put in. This will help your body replace the dead bone cells and build new blood vessels.

If you have osteonecrosis and your joint has collapsed, you might need a total hip replacement or a total knee replacement.

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