Avascular Necrosis (Osteonecrosis)

Avascular Necrosis (Osteonecrosis)

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What is Avascular Necrosis (Osteonecrosis)?

Avascular Necrosis (AVN), also known as osteonecrosis, is a degenerative bone condition caused by the loss of blood supply to the bone tissue, leading to bone death. It commonly affects weight-bearing joints such as the hip, shoulder, and knee, causing pain and potential joint collapse if left untreated. Early diagnosis and intervention are crucial to manage symptoms and prevent severe joint damage.

Avascular Necrosis (Osteonecrosis) Statistics

  • AVN affects approximately 10,000 to 20,000 new patients annually in the United States.
  • More than 80% of nontraumatic AVN cases are associated with corticosteroid use and excessive alcohol consumption.
  • Source: NCBI

    • Avascular Necrosis (Osteonecrosis) Anatomy

  • Affects the epiphysis of long bones, particularly in weight-bearing joints like the hip and knee.
  • Bone tissue death occurs due to the interruption of the subchondral blood supply.
  • Advanced stages lead to subchondral collapse and joint instability.

    • Avascular Necrosis (Osteonecrosis)
    Signs & Symptoms

  • Early stages may present minimal or no symptoms.
  • As the disease progresses, patients experience joint pain, stiffness, and limited range of motion.
  • Limping and difficulty performing weight-bearing activities are common in hip AVN.

    • Causes of Avascular Necrosis (Osteonecrosis)

  • Trauma (e.g., fractures, dislocations)
  • Prolonged use of corticosteroids
  • Excessive alcohol consumption
  • Medical conditions such as sickle cell anemia, lupus, and Gaucher disease

    • Risk Factors for Avascular Necrosis (Osteonecrosis)

  • Chronic corticosteroid use
  • Heavy alcohol use
  • Smoking
  • Chronic medical conditions (e.g., HIV, lupus, pancreatitis)

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    Prevalence of Avascular Necrosis (Osteonecrosis)

  • AVN is more prevalent in males due to higher rates of alcohol and tobacco use.
  • Nontraumatic AVN often affects individuals aged 30-50 years.

    • Assessment & Diagnosis of Avascular Necrosis (Osteonecrosis)

  • Physical examination and patient history are critical for initial assessment.
  • Imaging techniques like MRI and X-rays are essential for confirming the diagnosis and assessing the stage of AVN.

    • Rehabilitation & Physiotherapy for Avascular Necrosis (Osteonecrosis)

  • Focuses on pain management, maintaining joint mobility, and strengthening surrounding muscles.
  • Weight-bearing restrictions are often recommended to slow disease progression.
  • Physical therapy may include passive and active exercises, as well as gait training with assistive devices.

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    Avascular Necrosis (Osteonecrosis) FAQs

    The earliest signs of avascular necrosis include mild joint pain and stiffness, particularly during weight-bearing activities. As the condition progresses, the pain may increase, and joint mobility may become more restricted.

    AVN is diagnosed through a combination of patient history, physical examination, and imaging tests such as MRI and X-rays, which help in detecting early and advanced stages of the disease.

    While there is no cure for avascular necrosis, treatments such as physical therapy, medication, and surgery can slow its progression, alleviate symptoms, and improve joint function.

    Avascular Necrosis (Osteonecrosis) References

  • NCBI
  • Johns Hopkins Medicine
  • Cleveland Clinic

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