Avascular necrosis is actually the death of the bone tissue due to a blood supply lacking. Also referred to as osteonecrosis, it may result in tiny breaks in the bone and the bone's eventual collapse. A broken bone or dislocated joint could be an interruption for the blood flow for a particular section of bone. AVN (Avascular Necrosis) can also be associated with long-term utilization of high-dose steroid medications and excess alcohol intake.
Anyone could be affected, but the condition is most prevalent in people between the ages of 30 and 50.
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Avascular necrosis (AVN), or osteonecrosis or bone infarction, is the death of bone tissue attributed to interruption of the blood supply. At the onset, there may be no symptoms. But gradually joint pain may develop and may limit the ability to move. Complications include the collapse of the bone or joint surface.
In sickle cell disorder, the risk factor of having AVN is very high due to the complications from restricted blood supply to vital organs in the body. Up to 50% of sickle cell patients may develop AVN by the time they reach the age of 35. However, it is very rare in sickle cell trait (SCT), a much milder form of sickle cell disease in which patients are usually asymptomatic.
Treatment for AVN is recommended based on the stage of the disease coupled with the age of the patient. In Stage I, medication and crutches may be prescribed to provide relief and enable the bone to heal on its own. This treatment may require the patient to be non-weight-bearing for up to six months. It also has a failure rate greater than 80-percent.
Surgical treatment is recommended with a Stage II diagnosis, or very early in a Stage III diagnosis. A procedure, known as core decompression, typically involves drilling one large hole in the core of the affected bone, with or without a bone graft, to reduced pressure and improve blood circulation in the hip. Another surgical option is the vascularized fibular graft, which takes a healthy piece of bone from the fibula, along with the artery or vein, and transplants and reattaches it into the hip, to help the healthy bone growth. Recovery can take several months.
Because most patients are diagnosed in late Stage III or IV of the disease, when the bone quality of the femoral head is poor (subchondral fracture) or has collapsed, total hip replacement is the most successful treatment for AVN. This procedure replaces the damaged bone with artificial parts. Recovery takes about eight weeks. If left untreated, AVN progresses and results in pain and severe osteoarthritis. Treatment decisions for AVN are ultimately up to the patient and are based on his or her lifestyle and goals. If you are suffering from hip pain, talk with your primary care doctor about a referral to an orthopedic surgeon.