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AVN stands for Avascular Necrosis, also known as osteonecrosis. It is a condition characterized by the death of bone tissue due to a lack of blood supply. When the blood supply to a bone is disrupted or reduced, the bone cells start to die, leading to the collapse or destruction of the affected bone. AVN can occur in various bones in the body, but it most commonly affects the hip joint

Avascular Necrosis

Causes & Symptoms

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AVN can be caused by several factors, including:

  • Trauma: A sudden injury, such as a fracture or dislocation, can damage the blood vessels supplying the bone and disrupt the blood flow.
  • Steroid use: Long-term or high-dose use of corticosteroid medications, such as prednisone, can increase the risk of AVN. Steroids can affect the blood vessels and impair blood flow to the bones.
  • Excessive alcohol consumption: Chronic excessive alcohol intake can weaken the bones and impair blood flow, increasing the risk of AVN.
  • Medical conditions: Certain medical conditions, such as sickle cell disease, lupus, HIV infection, Gaucher's disease, and systemic lupus erythematosus, can increase the risk of AVN. These conditions can affect blood vessels or increase the likelihood of blood clotting.
  • Radiation therapy: High-dose or prolonged radiation therapy, particularly in the treatment of cancers, can damage the blood vessels and lead to AVN.

The symptoms of AVN commonly include:

  • Hip Joint pain: The pain is typically localized to the affected hip joint and can be mild to severe.
  • Hip Joint stiffness: Restricted range of motion and stiffness in the affected joint may occur.
  • Progressive difficulty with weight-bearing or hip joint movement: As AVN progresses, the joint function may be impaired, leading to difficulty in walking or performing activities involving the affected joint.


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The treatment options for AVN depend on the stage and severity of the condition. Treatment may include:

  • Medications: Nonsteroidal anti-inflammatory drugs (NSAIDs), Osteoporosis drugs, Cholesterol-lowering drugs, Medications that open blood vessels, Blood thinners or pain medications may be prescribed to manage pain and inflammation.
  • Supportive measures: The use of crutches, braces, or other supportive devices may be recommended to reduce weight-bearing stress on the affected joint.
  • Physical therapy: Physical therapy exercises can help maintain joint range of motion, strengthen surrounding muscles, and improve joint function.

Specific symptoms of shoulder pain experienced may vary depending on the underlying cause. It's important to note that these symptoms are general in nature and a proper diagnosis is crucial for determining the underlying cause of shoulder pain and developing an appropriate treatment plan. Some common symptoms associated with shoulder pain include:

  • Discomfort or pain in the shoulder region
  • Limited range of motion
  • Stiffness
  • Weakness
  • Swelling and inflammation
  • Clicking or popping sensation
  • Numbness or tingling
  • Difficulty in sleeping

Surgical procedure

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  • Core decompression: This surgical procedure involves drilling into the affected bone to reduce pressure and stimulate new blood vessel formation.
  • Bone transplant (graft). The graft is a section of healthy bone taken from another part of the body & can help strengthen the area of bone affected by avascular necrosis
  • Bone reshaping (osteotomy). A wedge of bone is removed above or below a weight-bearing joint, to help shift weight off the damaged bone.
  • Hip Joint replacement surgery: In severe cases where the hip joint is extensively damaged,hip joint replacement surgery may be necessary.
  • Regenerative medicine treatment. Bone marrow aspirate and concentration is a newer procedure that might help avascular necrosis of the hip in early stages. During surgery, a sample of dead hip bone is removed and stem cells taken from bone marrow are inserted in its place.