Avascular Necrosis : Symptoms, Causes and Treatment

General Information about Avascular Necrosis

Avascular necrosis is a condition where blood supply to bone is lost either permanently or temporarily. This loss of blood supply result in bone collapse due to death of bone tissues. When such avascular necrosis develops near a joint there is possibility of joint surface collapse.

Ends of long bones, like femur, are the most common sites for occurrence of avascular necrosis. Avascular necrosis can either affect one or multiple bones at same time or more than one bone at different times.

Avascular necrosis is also known by other common names aseptic necrosis, ischemic bone necrosis and osteo-necrosis.

Avascular Necrosis – Common Symptoms Normally, avascular necrosis does not display any symptoms in the initial stage. The symptoms are apparent in the advanced stage of avascular necrosis.

Some of the common symptoms include:

  • Joint pain is the primary symptom. One may feel this pain only after putting weight on affected joint in initial stage. However, this pain can be felt even during rest in advance stage. Pain can be either mild or severe in nature and developing gradually.
  • Disabling osteoarthritis is other symptom of avascular necrosis.

The period between onset of initial symptoms and advanced stage (joint function loss) may be varying from one individual to another. This period may be from numbers of months to more than a year.

Causes of Avascular Necrosis

There are number of causes behind development of avascular necrosis. Following are some of the common causes.

  • Injuries to bone: Blood vessels may get damaged due to dislocation or fracture to joint. Such damage of blood vessels can create interference to the circulation of the blood towards bone and may result in trauma-related avascular necrosis. According to available study reports, about 20% people with dislocated hip joint develop avascular necrosis
  • Steroid Medication: Generally corticosteroids like prednisone are used for treating diseases with inflammatory proprietary likerheumatoid arthritis, vasculitis, systemic lupus erythematosus and inflammatory bowel disease.
  • Blood disorders: Blood coagulation disorders
  • Excessive use of alcohol: Excessive use of alcohol and use of corticosteroid are considered as the prime causes of non-traumatic avascular necrosis. In alcoholics, blood vessels are blocked by the fatty substances. Such blockage may cause reduction in blood supply to bones which subsequently leads to development of vascular necrosis.
  • Increased pressure of bones: If the pressure within the bone increases this could help avascular necrosis to develop.

Risk factors for occurrence of Avascular Necrosis

Certain other diseases and treatments like pancreatitis, chemotherapy and radiation treatments, Gaucher’s disease and blood disorders (like sickle cell disease) can enhance the risk of developing vascular necrosis

Treatment of Avascular Necrosis

Treatment is required mainly to avoid break down of joints. If avascular necrosis is not treated at initial stage, majority of patients will suffer from severe pain and their movements will be restricted.

Factors like patient’s age, location of affected bone and stage of avascular necrosis are taken into consideration while selecting treatment.

Following are some of the common treatments.

  • Use of medicines for relief from pain and removal/reduction of blood clotting and fatty substances
  • Weight reduction of the joint or affected bone
  • Decompression of bone
  • Certain motion exercises
  • Electrical stimulation
  • Surgery or bone graft