AVN of the Hip – Causes, Prevention Tips & Proven Treatment Options Explained by Top AVN expert orthopaedic surgeon in Mumbai

Introduction to AVN of the Hip

Necrosis (AVN) of the hip, also known as osteonecrosis, is a serious condition where bone tissue in the femoral head (top of the thigh bone) begins to die due to a lack of blood supply. This eventually leads to bone collapse, joint destruction, and severe pain.

What Is AVN?

“AVN” stands for Avascular Necrosis, a medical term that literally means "death of bone tissue due to lack of blood supply." Without enough oxygen and nutrients, bone cells begin to die, and the structural integrity of the bone weakens over time.

Why the Hip Is Commonly Affected

The femoral head in the hip joint has a delicate blood supply, making it especially vulnerable. Even a small interruption in circulation—due to trauma, medications, or illness—can set the stage for AVN.

The Science Behind AVN (Avascular Necrosis)

Understanding Blood Supply to the Hip

The hip joint receives blood through small arteries that branch off and enter the femoral head. When these arteries are blocked, compressed, or damaged, the supply gets cut off—causing tissue death.

What Happens When Circulation Is Disrupted

Once the blood stops flowing, bone cells begin to die. Over weeks or months, the bone weakens, and tiny fractures form. Without treatment, the femoral head collapses, leading to arthritis and permanent disability.

Common Causes of AVN in the Hip Joint

Understanding the root cause is key to effective prevention and treatment.

Traumatic Injuries (Hip Fractures, Dislocations)

Injuries can directly damage blood vessels near the hip joint. Dislocated hips and femoral neck fractures are top culprits.

Long-Term Steroid Use

Corticosteroids are known to disrupt bone metabolism and reduce blood flow. Long-term or high-dose use is a major risk factor.

Excessive Alcohol Intake

Alcohol interferes with fat metabolism and may lead to fat buildup in blood vessels, restricting blood flow to the bones.

Blood Disorders (Sickle Cell Anaemia)

In sickle cell disease, abnormally shaped red blood cells can block small vessels, cutting off circulation to the bone.

Autoimmune and Chronic Illnesses

Lupus, HIV, and other chronic diseases may increase AVN risk due to inflammation, vascular problems, or the medications used.

Early Signs and Symptoms to Watch For

Groin or Thigh Pain

Pain often begins subtly and may feel like a deep ache in the groin, thigh, or buttocks.

Limping or Limited Mobility

As AVN progresses, walking becomes painful and stiff. Many patients develop a noticeable limp.

Pain That Worsens with Weight Bearing

Standing, walking, or climbing stairs can increase discomfort, especially after prolonged periods.

Who Is at Risk?

Several factors can raise the risk of developing AVN of the hip:

Age and Gender Considerations

While AVN can occur at any age, it’s most common in people between 30 and 60 years old. Men are more frequently affected than women.

Lifestyle Risk Factors

Heavy alcohol use, smoking, and prolonged use of corticosteroids are all major contributors. These habits impair circulation and bone health.

Genetic and Medical Predispositions

Conditions like sickle cell disease, lupus, and HIV increase susceptibility due to their impact on blood vessels and bone metabolism.

How AVN of the Hip Is Diagnosed

A timely and accurate diagnosis is critical to preserving hip function and preventing joint collapse.

Physical Examination

Doctors assess your hip mobility, check for tenderness, and observe how you walk or stand.

Imaging Tests:

• X-rays: May show joint space narrowing or bone collapse in later stages.

• MRI: The gold standard for early detection, it can identify bone changes before they appear on X-rays.

• CT Scans: Useful for detailed views of bone structure and staging.

Can AVN of the Hip Be Cured?

Difference Between Reversal and Management

Early-stage AVN may be reversible with aggressive conservative care or minimally invasive procedures. However, in advanced stages, treatment focuses on preserving function and relieving pain, not reversing damage.

Importance of Early Intervention

Timely treatment—especially in Stage I or II—can prevent or delay joint collapse, often avoiding the need for total hip replacement.

Prevention Strategies That Make a Difference

While not all causes of AVN are preventable, many lifestyle choices can greatly reduce your risk.

Avoiding Excessive Alcohol and Steroid Use

Managing Underlying Health Conditions

Protecting the Hip from Trauma

Non-Surgical Treatment Options

These are ideal for early-stage AVN and aim to reduce pain and delay progression.

Medications

• Bisphosphonates: May help slow bone loss.

• NSAIDs: Reduce inflammation and pain.

• Blood thinners: Used if clotting disorders are a factor.

Physical Therapy and Restricted Weight Bearing

Using crutches and avoiding weight-bearing activities gives the bone a chance to heal. Therapists help build strength and restore mobility.

Surgical Treatment Options

When conservative methods fail or AVN has progressed, surgery may be necessary.

Core Decompression

A small hole is drilled into the femoral head to reduce pressure, improve blood flow, and stimulate healing.

Bone Grafting

Healthy bone (often with stem cells) is transplanted into the necrotic area to support bone regrowth.

Osteotomy

This involves reshaping the bone to shift weight away from the damaged area.

Total Hip Replacement (THR)

Used in late-stage AVN (Stage IV), the damaged joint is replaced with a prosthetic implant, restoring mobility and relieving pain.

Latest Advances in AVN Treatment

Stem Cell Therapy and Regenerative Medicine

Harvesting and injecting mesenchymal stem cells into the hip shows promise in early studies to regenerate bone tissue.

Lifestyle Adjustments for Long-Term Management

Activity Modification

Avoid high-impact sports and activities that place excessive stress on the hip.

Use of Mobility Aids

Canes or walkers reduce load on the joint, helping control pain and maintain balance.

Pain Management Techniques

Acupuncture, heat therapy, and gentle stretching routines can complement medical treatments.

Living with AVN of the Hip

Mental Health Support

Chronic pain and mobility issues can lead to depression or anxiety. Therapy and support groups are beneficial.

Monitoring and Follow-Up Care

Regular imaging and doctor visits help monitor progression and evaluate treatment success.

Planning for Long-Term Mobility

Working with physical therapists and orthopedic specialists can help you stay mobile and active even as the condition progresses.

When to Seek Medical Help

Seek immediate care if you experience:

• Sudden hip pain

• Difficulty walking

• Stiffness that doesn’t improve

• Clicking or grinding in the hip

Early diagnosis can make all the difference.

FAQs About AVN of the Hip

1. Is AVN of the hip a permanent condition?

It can be if left untreated. However, early-stage AVN can often be managed effectively, and bone damage may be slowed or halted.

2. How long can you live with AVN without surgery?

This depends on the stage and cause. With early treatment, many patients avoid surgery for years or indefinitely.

3. Does AVN always lead to hip replacement?

Not always. If caught early, AVN can be managed conservatively or with less invasive surgery.

4. Can walking worsen AVN?

Excessive weight-bearing can accelerate joint damage. Doctors often recommend limited weight-bearing in early stages.

5. What is the most effective treatment for AVN?

This depends on the stage. Core decompression is often effective early on; total hip replacement is the standard in late stages.

6. Can AVN come back after treatment?

Yes, especially if risk factors like alcohol or steroids aren’t addressed. Regular follow-up is essential.

AVN hip pain

AVN of the hip is a serious condition, but it doesn't have to lead to lifelong disability. With early diagnosis, targeted treatment, and healthy lifestyle changes,