Avascular Necrosis (AVN) of the Hip — Treatment in Bangalore

Avascular necrosis (AVN or osteonecrosis) is death of bone in the femoral head due to loss of blood supply. The femoral head progressively collapses if untreated. Causes include steroid use, alcohol, trauma (neck of femur fracture), blood disorders (sickle cell), and idiopathic (unknown) in many cases.

Groin or hip pain, worse with weight-bearing and activity. In early stages pain may be mild or absent. As AVN progresses and the femoral head collapses, pain becomes severe and constant. Diagnosis is confirmed with MRI — the most sensitive imaging modality, detecting AVN before X-ray changes appear.

For some early-stage cases, joint-preserving procedures may be considered. Whether a procedure is suitable and what benefit it may offer depend on the extent of bone changes and an individual assessment. Once significant collapse has occurred, hip replacement may be discussed.

Core decompression involves drilling into the femoral head to reduce intraosseous pressure, restore blood flow, and stimulate healing. It is most effective in Stage 1–2 AVN before femoral head collapse. It can be combined with bone grafting or biological therapies for enhanced results.

High-risk groups include: patients on long-term corticosteroids (rheumatoid arthritis, lupus, transplant patients), heavy alcohol users, patients with sickle cell disease, patients who have had hip fractures, and patients who have received radiotherapy near the hip. Early MRI screening in high-risk patients allows detection before collapse.