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All About Avascular Necrosis - Causes, Diagnosis, Treatment, Surgery, Cost

Avascular Necrosis (AVN) or osteonecrosis is a bone disease resulting from the temporary or permanent loss of blood supply to the bones. Without blood, the bone tissue dies, and ultimately the bone may collapse. If the process involves the bones near a joint, it often leads to collapse of the joint surface. AVN is also known as aseptic necrosis and ischemic necrosis.

While it can affect any bone, avascular necrosis most commonly affects the ends (epiphysis) of the femur, the bone extending from the knee joint to the hip joint. Other common sites include the upper arm bone (hymerus), knees, shoulders, ankles and the jaw. The disease may affect just one bone, more than one bone at the same time, or more than one bone at different times. Osteonecrosis is the underlying diagnosis in approximately 10 percent of hip replacements.

Osteonecrosis affects both men and women. It can occur in people of any age, from children to the elderly. However, it is most common in people aged 30 to 50 years.

Avascular necrosis causes

Common risk factors leading to avascular necrosis include excessive steroid use, alcoholism, and injuries such as fracture, dislocation, or some other joint injury.

Other risk factors include radiation therapy, chemotherapy, and organ transplantation (particularly kidney transplantation). Osteonecrosis is also associated with a number of medical conditions, including cancer, lupus, blood disorders such as sickle cell disease, HIV infection, Gaucher`s disease, Caisson disease, gout, vasculitis, osteoarthritis, and osteoporosis.

However, osteonecrosis also affects people with no health problems and for no known reason. Following are some potential causes of osteonecrosis and other health conditions associated with its development.

Avascular necrosis symptoms

Patients with avascular necrosis may have no symptoms in the early stages but most experience joint pain as the disease progresses. At first, the pain occurs only when putting weight on the affected joint. Later, it occurs even when resting. Pain usually develops gradually, and may be mild or severe. If osteonecrosis progresses and the bone and surrounding joint surface collapse, pain may develop or increase dramatically. In some cases, particularly those involving the hip, disabling osteoarthritis may develop. The period of time between the first symptoms and loss of joint function typically ranges from several months to more than a year.

Avascular necrosis diagnosis

After performing a complete physical examination and asking about the patient`s medical history, the doctor may use one or more bone imaging techniques to diagnose osteonecrosis. Some of the tests used to determine the amount of bone affected and how far the disease has progressed are:

  • X-Ray
  • Magnetic Resonance Imaging (MRI)
  • Computed/Computerized Tomography (CT scan)
  • Bone Scan
  • Biopsy
  • Functional Evaluation of Bone

Avascular necrosis treatments

Appropriate treatment for osteonecrosis is necessary to keep joints from breaking down. Without treatment, most people with the disease will experience severe pain and limitation in movement within 2 years. The goal in treating osteonecrosis is to improve the patient`s use of the affected joint, stop further damage to the bone, and ensure bone and joint survival.

Treatments offered may be non-surgical or surgical.

Non-surgical treatments include medications, reduced weightbearing, range-of-motion exercises and electrical stimulation. Although these treatments may relieve pain or help in the short term, for most people they don`t bring lasting improvement.

Most people with AVN will eventually need surgery. A number of different surgical procedures are used to treat osteonecrosis. These include:

  • Core decompression: This surgical procedure removes the inner cylinder of bone, which reduces pressure within the bone, increases blood flow to the bone, and allows more blood vessels to form.
  • Osteotomy: This treatment involves reshaping the bone to reduce stress on the affected area.
  • Bone graft: This is the transplantation of healthy bone from another part of the body.
  • Arthroplasty/total joint replacement or joint resurfacing: Total joint replacement is the treatment of choice in late-stage osteonecrosis and when the joint is destroyed. When the hip joint is involved, the treatment offered to older patients is called total hip replacement or THR. For younger patients, a new, more promising treatment is hip resurfacing or metal on metal resurfacing (MOM resurfacing) which is a bone preserving alternative to THR and results in faster recovery.

Cost of avascular necrosis surgery

Sign up to find an orthopaedic doctor offering free consultation for avascular necrosis surgery. For a FREE personalized cost estimate of affordable avascular necrosis surgery in any of the several countries including USA, India, Singapore, Thailand, Turkey, etc., check out medical tourism with Healthbase.

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Healthbase, an award-winning* medical tourism facilitator in USA, is the trusted source for global medical and dental choices, connecting patients to leading healthcare facilities worldwide. We arrange a variety of medical tourism services from basic consultations to full service treatment abroad. We help you to take care of all your medical tourism details from arranging the surgery and financing options to visas, travel, lodging and tourism.

Healthbase caters to the needs of individual consumers, self-funded businesses, insurance carriers, benefit consultants, insurance agents, and third party administrators seeking affordable medical travel and dental travel options. Our state-of-the-art, easy to use, information rich web-based system makes it easy to coordinate international medical care including necessary travel and accommodation for patients and their companions, all at one place.

The cost of surgical care at our ever growing network of affiliated institutions is typically a fraction of the cost of care in the U.S. with equal or superior outcomes. Healthbase arranges first class services for patients at major internationally accredited hospitals in Thailand, India, Singapore, Malaysia, Philippines, South Korea, Turkey, Belgium, Hungary, Costa Rica, Panama, Brazil, Mexico, USA and is expanding to Canada, UK, Jordan,Taiwan, Argentina, New Zealand, Australia, El Salvador and Guatemala.

We offer over two hundred medical, dental and cosmetic procedures in various categories: Orthopedic procedures such as hip replacement, Birmingham hip resurfacing, artificial knee replacement, rotator cuff repair, knee surgery; Cardiac and Vascular procedures like heart bypass (multiple coronary artery bypass graft or CABG), aortic aneurysm repair, heart valve repair, heat valve replacement, angioplasty, RF Ablation; Spinal procedures such as spine fusion, laminectomy, disc replacement; Weight-loss procedures like gastric bypass, lap band, gastric sleeve; Eye procedures like LASIK; Cosmetic and Plastic surgery procedures such as breast augmentation, face lift, rhinoplasty (nose surgery), liposuction; Dental procedures such as orthognathic surgery, dental bridges, dental implants, dental crowns; dental veneers; and hundreds of other procedures in the departments of Urology, General surgery, Wellness and many more. The savings are up to 80% of typical US hospital prices.

Medical Tourism, also termed as Medical Travel, Health Travel, Health Tourism, Global Healthcare, Medical Vacation, Medical Value Travel, Medical Treatment Abroad, International Medical, Surgical Tourism, Surgery Abroad, Surgical Trip, Healthcare Abroad, Medical Outsourcing, offshore Medical and Overseas Medical, is the act of traveling abroad to receive medical, dental and cosmetic care. Significantly lower cost for best practice care is usually the primary motivation behind medical tourism although some medical tourists go abroad for immediate availability of procedures and to seek treatments that are not available in their home country. Patients frequently also take advantage of the opportunity to vacation and tour inexpensively in the foreign country while they are visiting for health care. Signup to know more about medical or dental tourism.

* - Awarded the "Best Website for Accessing International Medical Information for Patients/Consumers" by Consumer Health World 2007.


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