What is Hip Avascular Necrosis (AVN)?

Avascular necrosis is an ischemic change (loss of blood supply) that occurs in a portion of bone. 

This may be traumatic or non-traumatic and may occur in multiple areas, mostly commonly affecting the hip, knee, shoulder, and wrist. 

It tends to be most frequently occurring in middle-aged males 20 to 50 years of age and is often bilateral.  There has been an association with corticosteroids (cortisone) and a high incidence associated with excessive alcohol consumption. 

It may be idiopathic or an unknown reason that it occurs.  There are characteristic changes that are revealed on x-ray but in the early stages, an MRI may be necessary for evaluation.  Avascular necrosis of the hip can be significantly disabling.  Obviously, if it is in both hips, it is much more of a substantial problem than if it is just 1 hip; however, unilateral hip involvement can significantly disable an individual not only in their day-to-day life but also in higher levels of functioning and obviously in sports. 

Bo Jackson, a star professional two-sport athlete in football and baseball, developed avascular necrosis of his hip and ended his career resulting in a total hip replacement. 

Dr. Lox states that treatment for avascular necrosis of the hip has evolved and there are alternatives to total hip replacement.  There are various other surgical techniques that are available including cord decompression and stem cell therapy. 

Many patients are reluctant at a young age to pursue a hip replacement. 

Catching avascular necrosis in an early stage is an important step as progression of this disorder with further decaying bone and eventual arthritis of the joint limits treatment options.