Avascular Necrosis

Avascular Necrosis (osteonecrosis) of the hip is a condition that occurs when the blood supply to the hip bone is disrupted. As bone cells die without a blood supply, this can lead to collapse of the hip joint and arthritis.  Osteonecrosis is also called avascular necrosis or aseptic necrosis. It can occur secondary to steroid use, alcohol, medications, and other medical conditions.  If you have hip symptoms and have any of these conditions, please call us to arrange a consultation as you may be suffering from avascular necrosis.


Avascular Necrosis (AVN) develops in stages. Hip pain is typically the first symptom. This may be a dull ache or throbbing pain in the groin or buttock area. As the disease progresses, it slowly worsens and over time putting weight on the affected hip, and moving the hip joint will be painful.

How long it takes for the disease to progress through these stages varies from several months to many years. It is important to diagnose AVN early, because some studies show that early treatment is associated with better outcomes.


Although nonsurgical treatment options like medications or using crutches can relieve pain and slow the progression of the disease, generally treatment is surgical. Patients with osteonecrosis that is diagnosed in the very early stages (prior to femoral head collapse) are good candidates for hip preserving procedures.

  • Core Decompression
    This procedure involves drilling holes into the femoral head to relieve pressure in the bone and create channels for new blood vessels to the hip.
  • Vascularized fibula graft
    A segment of bone is taken from a bone in your leg (fibula) along with its blood supply (an artery and vein). This graft is transplanted into a hole created in the femoral neck and head.
  • Total hip replacement
    If AVN has advanced to femoral head collapse, the most successful treatment is total hip replacement. This involves replacing the damaged cartilage and bone with implants.