Avascular Necrosis Definition, Reason, Symptoms, Treatment & Prevention

Avascular Necrosis Definition, Reason, Symptoms, Treatment & Prevention


Avascular necrosis (AVN) is also known as osteonecrosis, aseptic necrosis, ischemic bone necrosis, and bone infarction. Necrosis is a general term for cell death.

AVN is a type of bone disease that undergoes necrosis. Damage to this bone occurs due to a lack of blood circulation to cells, causing cell death. The causes of circulatory disorders can vary, such as injuries, accidents, use of steroid drugs, or alcohol.

Complications that occur from this condition can be the distance between the joints that collapses and causes the bones to lose their smooth shape, causing osteoarthritis. AVN sufferers can experience joint pain, especially in the hips. Some sufferers even require joint replacement surgery.

Avascular Necrosis Symptom

Avascular necrosis (AVN) most often affects the hip joint area. In addition, the number two most commonly affected area is the knee joint. Other joints can also be affected by AVN but cases are quite rare, such as the shoulders, wrists, ankles, hands, feet and jaw.

In the early stages of AVN, there are no specific symptoms. When the cells die and the disease gets worse, then symptoms appear. Usually, symptoms will appear after a few months or about a year or more of joint problems.

The following are the symptoms that arise in order of severity of the disease:

  • moderate to severe pain around the affected joint
  • pain in the groin that spreads to the knee
  • pain that occurs due to the burden on the waist or knee
  • joint pain that is so severe that it limits movement

Pain can be very intense due to small fractures called microfractures. These fractures can cause the bone to collapse. Eventually, the joints also collapse and become arthritis. In the jaw there may also be protruding bones in the presence of pain or pus.

Avascular Necrosis Reason

The cause of Avascular necrosis (AVN) is an injury that disrupts or stops blood circulation in the bones. Other risk factors that are also associated with AVN are:

  • consuming too much alcohol
  • smoke
  • taking high doses of corticosteroids for a long time
  • diseases such as Legg-Calve Perthes

AVN can also strike healthy people spontaneously. The cause for this problem is still unknown. Men experience more AVN than women. AVN also usually occurs between the ages of 30 and 60.

There are also several other causes of AVN which, although rare, can also be found, such as:

  • Side effects of chemotherapy or radiotherapy
  • high cholesterol or triglyceride levels or both
  • Gaucher’s disease
  • HIV infection
  • lupus
  • undergoing an organ transplant such as a kidney
  • pancreatitis
  • blood disorders such as sickle cell anemia

Avascular Necrosis Diagnosis

The doctor will suspect Avascular necrosis (AVN) if the patient has bone pain that only occurs in a small area. To examine the bones, supporting examinations will be carried out such as: X-rays, MRI, CT- scanbone scan, and functional bone test.

A bone scan will be performed when an X-ray examination shows normal results. A functional bone test will be carried out when the doctor suspects AVN, but all other tests such as X-rays, MRI and bone scans also show normal results.

Avascular Necrosis Treatment

Treatment of Avascular necrosis (AVN) depends on patient characteristics such as age, causative factors, affected joint area, and severity. Treatment can also change with the change or severity of the disease.

The goals of treatment are to address the cause, reduce pain, help restore joint function, prevent further damage to the joints, and protect the bones and joints.

Treatment that can be given in the form of oral medication to injection therapy to reduce pain. Limiting activity and pressure on the affected joint is also necessary to prevent further damage to the bone and prevent microfractures. Range of motion exercises are also recommended to help maintain joint function.

Meanwhile, cholesterol drugs can be given to help improve blood circulation. Bisphosphonate medications can help prevent bones from collapsing. When all the treatment has been done but there is no improvement in the condition, then surgery may be needed. Several surgical procedure options include core decompression, bone grafting, vascularized fibula graft, osteotomy and total replacement.


There are several things that can help prevent bone and joint problems such as Avascular necrosis (AVN), including:

  • avoid consuming too much alcohol
  • quit smoking and avoid passive smoking conditions
  • avoid taking steroids without expert control
  • brush your teeth and visit the dentist regularly
  • See a dentist immediately if you have jaw pain or gum problems

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