Avascular Necrosis of the Hip

By Ehren Allen, Certified Manual Therapist/Physical Therapist

Avascular Necrosis of  the Hip

 By: Ehren Allen PT/Certified Manual Therapist 

JOI Image of the Hip

Medical illustration of the hip

What is AVN of the hip?

AVN (Avascular Necrosis) of the hip is a rare condition which can occur in the hip joint.  The hip joint is where the thigh bone (femur) connects to the pelvis.  It is a ball and socket joint.  AVN occurs when the blood supply to the end of the thigh bone (the ball of the joint) is compromised.  This causes tissue death (necrosis) in the the bone.

There are several reasons that the blood supply may become compromised in the end of the femur.

  • Trauma- This can be from a fracture or a dislocation of the hip.
  • Fat deposits in the vessels – this can occur from high lipid counts in the blood
  • Blood diseases – this may include conditions such as Sickle Cell Disease which may block blood flow to the bone.

Risks for developing AVN vary but may include:

  • Trauma
  • Steroid use – this may increase lipids in the blood
  • Radiation therapy from cancer treatment

 

How do you know if you have AVN of the hip?

Typically, the symptoms of AVN of the hip start with pain in the hip.  This may be worse with weight bearing and may alter the way that the hip moves during walking activity.  If pain persists, it is best to see a physician to evaluate the cause of the pain.  The physician will likely perform a physical examination to assess the movement and function of the joint.

AVN requires advanced diagnostic imaging to diagnoses it properly.  This may include:

  • X-ray
  • CT Scan
  • MRI
  • Bone scan

What is the best treatment for avascular necrosis of the Hip?

The first line of treatment for AVN of the hip is to manage pain and stiffness.  This may include pain medication or anti-inflammatory medications.  Physical therapy may be helpful to increase strength and ROM in the hip.

Managing any medical causes of AVN is also important with treating AVN.  This may include cholesterol meds to control lipid levels.

There are invasive procedures to manage AVN if medication management does no work.  The last line of treatment is a complete total hip replacement.

 

Can AVN heal itself?

AVN typically does not heal itself, but with treatment of the cause, improvements can be made.  Blood flow can be improved to the bone in some cases and bone tissue can regenerate.  Usually, though, issues progressively worsen and medical or surgical intervention is needed.

 

How painful is AVN of the hip?

AVN can cause varying levels of pain.  The pain may start mild and increase at the necrosis (tissue death) progresses.  This may cause an altered walking pattern which can lead to low back pain or knee pain as well.

 

If You have hip pain. the Jacksonville Orthopaedic Institute can help.  We evaluate and treat issues related to the hip, including AVN, all the time.  Give us a call at JOI-2000.

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