What Is Osteonecrosis?

Osteonecrosis, or avascular necrosis, results from a loss of blood supply to bone tissue. Bones and bone marrow are made up of living cells that require a consistent flow of blood to stay healthy. Without sufficient nutrients, the bone may die and the surrounding joints may begin to collapse, leading to pain, limited mobility and sometimes a need for joint replacement surgery.

While osteonecrosis can develop in any bone, it most often affects the thighs, hips, knees, shoulders, ankles and jaw. The most common causes include trauma, high-dose corticosteroid use, excessive consumption of alcoholic beverages and systemic lupus erythematosus. Osteonecrosis can also develop due to decompression sickness (the “bends”), an HIV infection, certain blood disorders and radiation treatment.

What are the symptoms of osteonecrosis?

Usually, osteonecrosis causes localized bone pain. For instance, if the hip joint is affected, an individual may experience pain in his or her groin area. The discomfort may also worsen with movements that exert pressure on a damaged bone.

How is osteonecrosis treated?

Osteonecrosis treatment often begins conservatively with pain medications and lifestyle adjustments (mainly to limit weight-bearing activities that worsen symptoms). This approach can be particularly effective for addressing early-stage osteonecrosis in small areas of bone. On the other hand, more advanced treatment may be necessary to address progressive bone collapse. Some options include:

• Core decompression surgery – A surgeon can remove a piece of bone to improve blood flow to the affected area.
• Osteotomy – A surgeon can remove dead bone tissue and then reposition the remaining healthy bone to better support the weight-bearing joint surface.
• Arthroplasty – If bone collapse has occurred in a hip or knee joint, a joint replacement can improve comfort and function.
• Bone grafting – A surgeon can remove a small piece of healthy leg bone and then transplant the graft to an area of dead bone.

At Advanced Orthopaedics & Sports Medicine of Houston, Texas, we offer a full range of conservative and surgical treatment options for osteonecrosis. When necessary, our board-certified and double-board-certified surgeons can perform total joint replacements and other procedures. In many cases, we are able to use advanced, minimally invasive techniques to help our patients recover more quickly with less pain and scarring than would typically accompany a more invasive procedure.

If you’d like to learn more about osteonecrosis symptoms and treatment options, contact Advanced Orthopaedics & Sports Medicine of Houston, TX, today.