Avascular Necrosis Of Femoral Head
The earlier doctors diagnose and treat avascular necrosis, the better the chances of a good recovery. Learn more about this condition and its causes with this guide to take the right steps towards its management.
Written by
Last updated on 3rd Jul, 2025
Avascular necrosis (AVN) refers to a condition in which the blood flow to the bone tissue gets drastically reduced. This ultimately results in the death of the bone. Most individuals usually suffer from avascular necrosis in their hips, shoulders, ankles, and knees. It generally affects individuals within the age group of 30-65 years old.
For some individuals, AVN is asymptomatic and is discovered incidentally. However, when left untreated for long, the condition can worsen over time, leading to the affected bone to collapse within a few months or years.
Avascular necrosis of the femoral head is when there is a disruption of the blood supply to the proximal femur (the part of the femur bone nearest to the centre of the body).
Causes and Risk Factors
Some of the known causes of AVN include,
Traumatic avascular necrosis: This can occur after an individual accidentally breaks their bones or dislocates a joint.
Non-traumatic avascular necrosis: This happens when an individual is suffering from a medical condition that restricts the flow of blood to the bone tissue.
Apart from these, people receiving medical treatment for pre-existing health conditions like sickle cell anaemia, diabetes, cancer treatments, lupus, or HIV can also develop AVN.
Individuals who indulge themselves in too much smoking, alcohol, and corticosteroids run a high risk of developing avascular necrosis. In addition to this, some of the other common risk factors for avascular necrosis are,
Decompression diseases
Autoimmune disease
Caisson disease (this is when gas bubbles form in the blood and tissues due to a rapid decrease in pressure) and
Hyperlipidemia (this refers to a condition where a person develops high levels of fats in their blood), among others.
Symptoms and Early Signs
Most people suffering from AVN usually do not display any symptoms in the initial stage. In fact, for some, it might be weeks or months before there is a clear indication of this condition.
Nonetheless, some of the most common signs that appear over time are,
Pain in the joint, which can gradually increase if the bone collapses
Groin pain if the affected area is near the hip
Limping
Restricted range of motion
Difficulty with overhead movement
Get Your AVN Symptoms Checked
Diagnosis
Avascular necrosis is diagnosed primarily through a physical examination conducted by a healthcare professional. They will ask the patient about their symptoms and medical history. Additionally, it is very important to disclose all crucial information related to any medicine or vitamin supplements consumed by the affected individuals to medical experts.
Based on the results of the physical exam, the healthcare specialist will recommend one or more of the following tests.
X-Ray: This is done to uncover any bone changes that are common during the late stages of AVN.
Computed tomography scan (CT/CAT scan): It is an imaging test done to make detailed images of the body. It will reveal significant details of the bones, fat, muscles, and organs.
Magnetic Resonance Imaging (MRI): Large magnets, radio frequencies, and a computer are used to display comprehensive images of the organs and structures in a human body.
Biopsy: It is conducted to detect cancer or other abnormal cells and remove tissues from the affected bone.
Radionuclide bone scan: It helps display blood flow to the bone, as well as cell activity within the bone.
Stages of Avascular Necrosis
There are mainly four stages of avascular necrosis.
Pre-collapse stage: There is very minimal to no symptoms at all during this stage. Imaging tests like MRI or X-ray are done to detect any bone damage in an individual’s body. The bone tissue is still alive. However, there is a disruption in the blood flow to the bone, which causes the bone cells to die off.
Early collapse stage: During this phase, the bone tissue begins to break down. Individuals may experience an onset of pain in the affected area, and the bone may start to collapse. This can result in more damage to the joint.
Late collapse stage: This is one of the most advanced stages of AVN, where the bone has collapsed entirely. Some of the most common symptoms are extreme pain and difficulty in standing or walking.
Arthritis: Arthritis is the last phase of AVN. The joint can no longer function properly, and the bones start to rub against each other. Doctors usually prescribe a joint replacement surgery to reduce the pain and restore mobility.
Treatment Options
If AVN is caused by an underlying condition, then part of the treatment will be focused on that. For example, if an individual is suffering from AVN due to a blood disorder, then specific medicine will be prescribed to treat it.
Generally, if avascular necrosis is detected at an early stage, doctors recommend pain relievers and certain lifestyle changes. The patient will be asked to use crutches if their hips, knees, or ankles are affected.
While some non-surgical treatments can slow down the progression of AVN, most patients usually require surgery. They include,
Bone graft
Removing part of the affected bone
Partial or complete joint replacement
Cutting the bone and altering its alignment
Complications
In most cases, advanced avascular necrosis leads to osteoarthritis (breakdown of joint cartilage) and permanently decreased mobility. However, in comparatively more severe cases, individuals might be required to opt for joint replacement surgeries.
Management and Lifestyle Adjustments
The treatment for AVN will be directly dependent on the intensity of damage to the bones. If it is limited to smaller bones that don’t bear weight, a healthcare professional might suggest rest and activity modification. These include,
Protected weight-bearing: Doctors will recommend using assistive devices such as crutches or walkers. The goal is to minimise the use of the affected joint for bearing their body weight.
Activity modification: Affected individuals will be required to make certain adjustments to their daily activities. For example, prolonged standing or sitting may hinder healing.
Pharmacological interventions: NSAIDs (Nonsteroidal anti-inflammatory drugs) like ibuprofen or naproxen will be prescribed to alleviate pain and reduce inflammation.
Prevention Techniques
Avascular necrosis might not be completely preventable. But, there are certain measures that can be taken to reduce the risk of developing this condition. They include,
Cutting off the consumption of tobacco in any form
Reducing alcohol intake
Closely tracking cholesterol levels
Reducing the dosage of corticosteroids (usually prescribed for chronic medical conditions) after talking to a healthcare professional.
Individuals who suspect they might have AVN must consult their nearest medical experts immediately. Since it is a progressive condition, the sooner the diagnosis, the better the chances of slowing down the symptoms.
Conclusion
Avascular Necrosis is a painful condition that can significantly affect the quality of life of an individual. Currently, there is no cure for this; however, non-surgical treatments can help to manage the symptoms for a while. But, eventually, affected people will have to undergo a joint replacement to be completely pain-free.
It is very important for everyone who experiences any of the common symptoms of AVN, like pain, stiffness, or limited range of motion, to consult their healthcare providers. Early detection and treatment can prevent further damage and improve outcomes.
Get Your AVN Symptoms Checked
Dr. Manoj Dinkar
Orthopaedician
15 Years • MBBS, Dip (Orthopaedics)
New Delhi
THE DOCTORS NESST, New Delhi
Dr. Anil Sharma
Orthopaedician
42 Years • MBBS, MS Orthopedics
New Delhi
AAKASH MEDSQUARE, New Delhi
Dr. Pradeep Lucas
Orthopaedician
7 Years • MBBS, Diploma in Orthopaedics, Fellowship in DFSI
Bengaluru
Revival Multispeciality Clinic, Bengaluru
Dr. Padam Singh Gautam
General Physician/ Internal Medicine Specialist
43 Years • M.B.B.S (WARDHA M. S.), F.A.G.E. (MANIPAL), F.A.I.M.S. (Pb.), M.A.I.M.S. (Pb.), M.R.S.H. (LONDON)
Noida
Dr Padam Singh Gautam Fracture Clinic, Noida
(225+ Patients)
Dr. Anupam Gupta
Orthopaedician
30 Years • MBBS, MS (ORTHOPAEDICS)
Agra
OM MEDICAL COMPLEX KHANDARI AGRA, Agra
