Avascular Necrosis of the Hip | Osteonecrosis Causes, Symptoms, & Treatment | MedStar Health

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Hip osteonecrosis, also called avascular necrosis of the hip, can cause severe pain and debilitation. At MedStar Health, our experienced hip surgeons perform thousands of surgeries each year, including hip replacement surgery for this type of condition.

We pride ourselves on offering the least invasive surgical options to help you recover quickly from surgery and return to your regular life faster. Our surgeons take the time to thoroughly explain your unique condition to you and walk you through your treatment plan from beginning to end. We will always encourage non-surgical options when possible and recommend surgical options only when necessary.

What is avascular necrosis of the hip?

This condition is characterized by loss of blood supply in the bone. Bone is living tissue, requiring blood to remain healthy and functional. Therefore, significant blood loss will eventually cause the bone to collapse and die. Osteonecrosis most commonly affects the hip, but can also occur in the shoulders, ankles, or knees.

What causes avascular necrosis of the hip?

It is often the result of one of the following:

  • Trauma
  • HIV infection and treatment
  • Sickle cell disease
  • Radiation therapy/chemotherapy
  • Autoimmune diseases
  • Decompression sickness
  • Metabolic disorder

What are the symptoms?

In early stages, this condition usually has no noticeable symptoms. As the disease progresses, it can cause the following symptoms, which may persist over a span of several months, before the bone eventually collapses:

  • Hip pain
  • Pain that becomes more constant
  • Inability to use the hip
  • Loss of range of motion

How is it diagnosed?

At first signs, it is important to speak with an orthopedic surgeon who specializes in bone loss and hip surgery. MedStar Health is home to experts in a wide range of hip conditions who have years of experience diagnosing and treating avascular necrosis of the hip. Your initial exam with one of our doctors will likely include the following:

  • Medical history evaluation : Your doctor will ask you about your past medical history, including the health of your hip.
  • Physical exam : During a physical exam, the doctor will evaluate the hip area looking for signs of bone loss.
  • Imaging tests : Your doctor will likely conduct imaging exams as well to evaluate the extent of the hip bone loss.

What are the best treatments?

When this condition is caught early enough, you may be able to treat it with conservative options, including:

  • Medication to decrease swelling and pain

  • Avoiding activities that cause pain or pressure on the affected bone

  • Crutches to take weight off the damaged area

  • Range of motion exercises

  • Physical therapy

  • Core decompression of the hip

Conservative options can slow down the bone degradation process. However, most people will eventually need treatment to repair the bone damage. This may include: