Avascular Necrosis of the Femoral Head

Avascular Necrosis of the Femoral Head

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What is Avascular Necrosis of the Femoral Head?

Avascular necrosis (AN) of the femoral head is a serious condition where the blood supply to the femoral head is disrupted, causing bone tissue death. This leads to bone collapse, pain, and loss of hip function. Early diagnosis and intervention are crucial to prevent joint destruction and improve outcomes.

Avascular Necrosis of the Femoral Head Statistics

AN affects approximately 10,000 to 20,000 new individuals each year in the U.S., with a higher prevalence in men aged 30 to 50. Source

Avascular Necrosis of the Femoral Head Anatomy

The femoral head is the ball-shaped upper end of the femur that fits into the hip socket, essential for hip movement and weight-bearing.

Its blood supply comes primarily from the medial femoral circumflex artery.

Avascular Necrosis of the Femoral Head
Signs & Symptoms

Groin pain, often radiating to the knee or buttocks.

Painful range of motion, especially with internal rotation.

Difficulty walking or limping.

Causes of Avascular Necrosis of the Femoral Head

Trauma, such as fractures or dislocations.

Corticosteroid use.

Excessive alcohol consumption.

Blood disorders, such as sickle cell disease.

Risk Factors for Avascular Necrosis of the Femoral Head

Prolonged corticosteroid use.

Heavy alcohol use.

Smoking.

Genetic predisposition and chronic diseases like lupus.

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Prevalence of Avascular Necrosis of the Femoral Head

AN is more common in men aged 30-50, affecting about 10,000 to 20,000 people annually in the U.S.

Assessment & Diagnosis of Avascular Necrosis of the Femoral Head

Physical examination focuses on groin pain and limited range of motion.

X-rays for moderate/late stages; MRI for early detection.

Crescent sign on X-rays indicates subchondral fractures.

Rehabilitation & Physiotherapy for Avascular Necrosis of the Femoral Head

Reduce weight-bearing with crutches or walking aids.

Implement range of motion and strengthening exercises.

Focus on reducing risk factors such as alcohol and smoking cessation.

Post-surgery physiotherapy includes mobility training and strengthening exercises.

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Avascular Necrosis of the Femoral Head FAQs

What are the early symptoms of avascular necrosis of the femoral head?

Early symptoms include groin pain that may radiate to the knee or buttocks, and pain during hip movements, particularly internal rotation.

How is avascular necrosis of the femoral head treated?

Treatment varies based on severity, including non-operative methods like physiotherapy and weight-bearing restrictions, or surgical options such as core decompression and bone grafting.

Can avascular necrosis of the femoral head be prevented?

Prevention focuses on managing risk factors like reducing corticosteroid use, avoiding excessive alcohol, and treating underlying health conditions.

Avascular Necrosis of the Femoral Head References

Barney J, Piuzzi NS, Akhondi H. Femoral head avascular necrosis

Stanford Medicine Core Decompression

Hsu H, Nallamothu SV. Hip Osteonecrosis