Avascular necrosis is a condition that arises if the bone tissue dies due to the limited blood supply. If an individual has this condition, the bone deteriorates after small-sized breaks occur. Generally, the condition affects the thigh bone in the hip region but can affect other bones as well include the elbow, jaw, wrist, hand, knee, shoulder and the foot. The condition progresses over time but only causes minor symptoms.
What are the causes?
There are various reasons for the reduced supply of blood to the bone. The common reasons include the following:
- Previous bone injuries in which the blood supply is disrupted such as after a fracture or dislocation.
If the wrist is involved, wrist pain occurs along with weakness in the fingers. - Prolonged use of oral steroids
- Excessive intake of alcohol
- Using certain medications such as bisphosphonates (rare)
- Congenital ailments
Indications
Avascular necrosis might not trigger any symptoms but some experience pain or loss of movement in the affected joint.
- If the condition affects the hip, there is possibility for groin pain that radiates down the thigh to the knee.
- If the wrist is involved, wrist pain occurs along with weakness in the fingers.
- In case the shoulder is affected, it results to pain or discomfort along with stiffness in the upper arm.
- If the knee is affected, there is pain in the lower point of the thighbone.
Take note that in some cases, the pain might arise abruptly and can be severe, but might “burn out” over time.
Management of avascular necrosis
There are various treatment options for avascular necrosis. The treatment is based on varying factors including the age, site and degree of bone affected, underlying cause and phase of the disease.
The treatment is aimed on ensuring the survival of the bone and joint to prevent further damage and allow the individual to use the joint.
Some of the commonly used treatment options include:
- Reduced weight bearing – if diagnosed early, lowering the amount of weight bearing is beneficial in removing weight from the affected joint to lower the risk for microfractures. This might require the use of crutches or limited activities.
- Core decompression – this is a surgical procedure where the interior bone layer is removed to allow improved blood flow to the affected area. This is highly effective for individuals in the early phase of the disease.
- Osteotomy – this surgical procedure involves reshaping either the affected bone or adjacent bones to reduce the stress on the affected area. This is ideal for individuals in the advanced phase of the disease and those that affects a large area of bone.
- Bone graft – this surgical procedure involves transplanting healthy bone to the area affected by avascular necrosis.
- Arthroplasty – this treatment is utilized for the late-phase necrosis and if the joint is destroyed. The affected joint is replaced with artificial parts to recreate an operational joint.