Osteonecrosis, aka avascular necrosis, is a bone condition in which part of your bone dies due to the lack of blood. Other terms used in reference to this bone death condition are aseptic necrosis or ischemic bone necrosis.
As osteonecrosis worsens, it can cause your bones to break and ultimately collapse. The location along a bone most often experiencing death is the end. And avascular necrosis can happen to a single bone or multiple ones.
The hip end of the femur bone is the most common site for osteonecrosis. However, avascular necrosis is known to occur in the upper arm, knee, shoulder, ankle, foot, spine and jaw.
Initially osteonecrosis bone death may not cause any symptoms. As the health condition progresses, you’ll begin to notice joint pain, much like arthritis. Eventually, range of motion may be reduced and resting the joint may not relieve your pain.
Other avascular necrosis associated symptoms will depend on where and which bone is dying. An assortment of symptoms include:
- knee pain
- wrist pain
- finger weakness
- radiating thigh pain
- standing, walking pain
- shoulder pain & stiffness
Ofttimes, osteonecrosis resting joint pain develops following some type of severe bone trauma, like after a fracture or dislocation. Yet, there are other associated causes and risks for this type of bone death, such as
- HIV infection
- radiation therapy
- Gaucher disease
- heavy alcohol use
- kidney transplantation
- blood clotting disorder
- Caisson disease ~ the “bends”
- blood disorders ~ sickle cell anemia
- high doses of corticosteroids ~ prednisone
Leaving avascular necrosis untreated can lead to long term resting joint pain and functional disability.
There is no single treatment for osteonecrosis. If a condition is causing your bone death, then treatment for it helps prevent further bone loss.
Early stage treatment of avascular necrosis may involve:
- bisphosphonates ~ may slow progression
- NSAIDs for pain relief ~ aspirin & ibuprofen
- weight bearing & stress reduction ~crutches
- core decompression surgery ~ inner layer bone removal
- electrical stimulation ~ may encourage new bone growth to replace damaged areas
Surgical treatment for advanced avascular necrosis include:
- joint replacement
- bone transplant (graft)
- bone reshaping (osteotomy)
Some with osteonecrosis have an outcome of complete healing. Whereas with others, it can cause osteoarthritis or permanent disability.