Avascular necrosis is a painful bone condition that gets worse over time and can affect your mobility. It occurs when something cuts off blood flow to one of your bones. Causes include broken bones, dislocated hips, radiation therapy and alcohol misuse. Most people need surgery — sometimes joint replacement — to ease pain and improve mobility.
Avascular necrosis happens when something blocks the flow of blood to your bone tissue. Your bones are constantly changing as your skeletal system makes new bone tissue to replace aging bone tissue that eventually breaks down and dies.
Think of this as a cycle — your body makes new tissue to replace the tissue that’s breaking down and dying. This pattern needs to happen correctly to keep your bones healthy and strong. Blood carries the nutrients and oxygen bones need to stay healthy and regenerate. Without blood flow, your skeletal system can't make new bone tissue fast enough. The dying bone begins to crumble and eventually collapses.
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Between 10,000 and 20,000 Americans develop avascular necrosis every year. It can affect all ages and genders, but this condition happens most often to people in their 30s and 40s.
Avascular necrosis can affect bone tissue in any joint, but typically targets your hip. Other joints that can develop avascular necrosis include:
Bone fractures or disease that prevent blood flow to bone tissue causes avascular necrosis. About 20% of avascular necrosis cases happen without an obvious cause.
Known causes of avascular necrosis are:
Avascular necrosis is more likely in some bone fractures than others. Common bone fractures that lead to traumatic avascular necrosis are:
There are several medical conditions or treatment that can lead to avascular necrosis:
Some lifestyle activities that increase that risk are:
It might be weeks or months before you notice symptoms that might indicate you have avascular necrosis. Here are some symptoms that appear over time that could be signs of avascular necrosis:
Your healthcare provider will assess your symptoms and perform a physical exam. You may get one or more of these tests:
Your treatment will depend on the amount of damage to your bones. Potential treatments you might have if your bone damage is limited to smaller bones that don't bear weight include:
In most cases, you'll need surgery to treat your avascular necrosis. Surgical options can include:
You might not be able to prevent avascular necrosis, but there are steps you can take to reduce your risk:
Treatment can slow the progress of avascular necrosis, but there is no cure. Most people who have avascular necrosis eventually have surgery, including joint replacement. People who have avascular necrosis can also develop severe osteoarthritis.
Avascular necrosis is a progressive condition that gets worse over time. If you have avascular necrosis, you should monitor your symptoms, such as pain and mobility.
You should call your healthcare provider if you have:
You might want to ask your healthcare provider these questions:
A note from Cleveland Clinic
Avascular necrosis is a painful condition that can significantly affect your quality of life. Talk to your healthcare provider if you have illnesses or take medications that increase the risk you will develop avascular necrosis. Your provider will explain symptoms that might be signs of avascular necrosis. Early diagnosis and treatment can delay the condition's progress.
Last reviewed by a Cleveland Clinic medical professional on 09/13/2021.
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