Avascular necrosis (AVN) refers to a gradual loss of bone tissue due to a decreased or cut-off blood supply. Your bones require regular oxygen and other nutrients in order to develop new tissues—when your blood cannot provide those nutrients, your bones eventually weaken and break down. As many as 20,000 individuals in the U.S. develop AVN each year.
If not properly treated, this condition can affect your mobility and contribute to other health issues, such as arthritis. Speak with a Bayhealth orthopedic expert about AVN.
Signs and Symptoms
While the condition typically affects your hips, AVN can develop in any bone, including your ankles, arms, jaw, knees and shoulders.
Symptoms may develop gradually, causing stiffness and pain that increases over time. You may also experience intermittent pain during movement or when applying weight to the affected area.
Eventually, this discomfort could occur while sitting or lying down. Be advised that common symptoms of AVN could indicate other bone or joint conditions.
Risk Factors
Although around 20% of AVN cases don’t have clear causes, the condition commonly develops due to an identifiable trauma or ailment. Among the factors that could increase the risk for developing AVN are the following.
- Injury: Physical trauma, such as a joint dislocation or bone fracture, may result in damage to blood vessels, which in turn could decrease blood flow to your bones.
- Alcohol Use: Heavy alcohol use—meaning daily consumption over several years—could cause fatty deposits to form in your blood vessels, blocking the flow of blood and contributing to AVN.
- Steroid Use: High doses of corticosteroids, including prednisone, have been known to increase the risk of developing AVN at some point.
- Other Conditions: Illnesses and medical conditions that reduce blood flow can increase the risk of developing AVN. Such conditions include sickle cell anemia, Gaucher’s disease, HIV, pancreatitis, lupus, diabetes, leukemia and osteoporosis.
- Other Treatments: Certain treatments for other conditions have been known to decrease blood flow or bone strength, which could lead to AVN. Those treatments include radiation therapies for cancer and organ transplantations.
How We Diagnose AVN
Our orthopedic experts use the following procedures to diagnose AVN.
- X-Ray: A common medical imaging procedure, X-rays use radiation to capture colorless images of your bones, joints and soft tissue.
- Magnetic Resonance Imaging (MRI): A combination of a magnetic field and radio waves creates three-dimensional images of specific areas of your body.
- Computerized Tomography (CT) Scan: Certified experts use computer-processed X-rays to generate a scan of your body in “slices” to create highly accurate images.
- Biopsy: A surgeon removes part of the affected area so that it can be examined under a microscope for signs of avascular necrosis.
- Radionuclide Bone Scan: During this nuclear imaging procedure, our tech injects you with a small amount of radioactive material that can be detected by a scanner. This provides images of blood flow as well as cellular activity.
Treatment Options
Our board-certified orthopedic experts work collaboratively to outline a treatment plan that addresses the damage already caused by AVN and improves the function of your bones.
Based on several factors, we may prescribe medication, surgery—or both.
Medical Therapies
Among the medical treatments we provide are the following.
- Nonsteroidal Anti-Inflammatory Drugs
- Osteoporosis Drugs
- Cholesterol-Lowering Drugs
- Blood Thinners
Surgical Approaches
Among the surgical options we provide are the following.
- Core Decompression: Small holes (called cores) are drilled into the bone, improving blood flow and relieving pressure on the affected area.
- Bone Graft: Also known as bone transplants, bone grafts involve taking a piece of healthy bone from elsewhere on the body and using it to repair damaged bone.
- Osteotomy: Our surgeons use advanced techniques to reshape or realign your bone by cutting into it and removing the damaged area.
- Joint Replacement: If other treatment approaches haven’t addressed the pain and disability caused by AVN, our experts may replace the joint with an artificial one. Joint replacements are most commonly performed on hips and knees.
Depending on the area of your body affected by AVN, our experts may also prescribe the use of an assistive walking device such as a cane or walker, to limit the weight placed on the bone.
Speak with an orthopedic expert at Bayhealth about avascular necrosis (AVN).