Avascular Necrosis (Osteonecrosis)
Treatment for Avascular Necrosis
The goals of treatment for AVN are to improve or ensure function of the affected joint, stop the progression of bone damage, and reduce pain.
The best treatment will depend on a number of factors, including:
- Your age
- Stage of the disease
- Location and amount of bone damage
- Cause of AVN
If the cause of your avascular necrosis is identified, treatment will include efforts to manage the underlying condition. For example, if AVN is caused by blood clots, your doctor will prescribe medications to dissolve clots. If inflammation of the arteries is responsible, your doctor may prescribe anti-inflammatory medicines.
If avascular necrosis is caught early, treatment may involve taking medications to relieve pain or limiting the use of the affected area. If your hip, knee, or ankle is affected, crutches may be necessary to take weight off the damaged joint. Your doctor may also recommend range-of-motion exercises to help keep the affected joint mobile.
While these nonsurgical treatments may slow the progression of avascular necrosis, most people with the condition eventually need surgery.
Surgical options include:
Bone grafts, which involve removing healthy bone from one part of the body and using it to replace the damaged bone
Osteotomy, a procedure that involves cutting the bone and changing its alignment to relieve stress on the bone or joint
Total joint replacement, which involves removing the damaged joint and replacing it with a synthetic joint
Core decompression, a procedure that involves removing part of the inside of the bone to relieve pressure and allow new blood vessels to form
Vascularized bone graft, a procedure that uses the patient's own tissue to rebuild diseased or damaged hip joints; the surgeon first removes the bone with the poor blood supply from the hip and then replaces it with the blood-vessel-rich bone from another site, such as the fibula, the smaller bone located in the lower leg.