Osteonecrosis, Avascular Necrosis, is defined at bone death caused by poor blood supply to the area of bone. The most common bones affected are the hip and shoulder. however the knee, elbow, wrist, and ankle can also be affected. AVN is the result of [art of the bone not receiving enough oxygenated blood causing dead areas of bone. Over time this causes joint deterioration and severe arthritis. Th
ere are numerous causes of AVN including severe trauma such as a break or crushing of a bone, or disease. The following can also be a cause osteonecrosis:
Long-term treatments with steroids
Excessive alcohol use
Sickle cell disease
Radiation therapy
Gaucher disease
Decompression sickness from a lot of deep sea diving
Dislocation or fractures around a joint
Symptoms of this disease do not typically present themselves in the early stages. You may have the following symptoms as the damage to the bones worsen:
Pain in the joint that may increase over time, sever pain when the bone collapses
Pain that occurs even at rest
Limited range of motion
Groin pain, if the hip joint is affected
Limping, if the condition occurs in or below the hips
Signs and tests
Your physician will ask you many questions and do several diagnostic exams such as the following:
X-ray
MRI
Bone scan
CT scan
Treatment
"If the condition is caught very early, you will take pain relievers and limit use of the affected area. This may include using crutches if your hip, knee, or ankle is affected. You may need to do range-of-motion exercises. Nonsurgical treatment can often slow the progression of osteonecrosis, but most people will need surgery." Surgical options include:
A bone graft
A bone graft along with its blood supply (vascularized bone graft)
Cutting the bone and changing its alignment to relieve stress on the bone or joint (osteotomy)
Total joint replacement
Removing part of the inside of the bone (core decompression) to relieve pressure and allow new blood vessels to form
Support Groups
You can find more information and support resources at the following organizations:
National Osteonecrosis Foundation -- www.nonf.org
ON/AVN Support Group Int’l Association --http://osteonecrosisavnsupport.org/
The Arthritis Foundation -- www.arthritis.org
Center for Osteonecrosis Research and Education (CORE) -- http://www.osteonecrosis.org/
