What You Need to Know About Osteonecrosis of the Hip

This article is part of the the Ultimate Guide to Hip Pain Relief.

There are many conditions and diseases that may result in hip pain. Hip pain can not only put a damper on the activities you once loved, but in some cases the underlying issue may be causing more damage than you think.

One such disease is osteonecrosis, also known as avascular necrosis (AVN). Osteonecrosis of the hip is a rare, but is a serious cause of hip pain and disability. 

IBJI recently chatted with Dr. Jeffrey Ackerman, board certified and fellowship trained orthopaedic surgeon. He is a comprehensive hip surgeon who is an expert on avascular necrosis of the hip and is one of a select group of surgeons that performs core decompression with autologous stem cell treatment for avascular necrosis. Dr. Ackerman tells us the main things that are important to know about osteonecrosis of the hip. His responses—below—have been edited and condensed for space.

What is Osteonecrosis of the Hip?

“Osteonecrosis involves an interruption to the microvascular blood supply to the femoral head, or ball of the hip joint,” says Dr. Ackerman, “Similar to cutting or blocking the roots to a tree, parts of the femoral head can begin to die. Depending on the severity, it can lead to complete destruction of the femoral head leading to severe, debilitating pain, necessitating hip replacement surgery.”

Causes of Osteonecrosis of the Hip

Common causes of osteonecrosis include:

• Certain medication side-effects
• Chronic alcohol use
• Hereditary conditions

Learn more about osteonecrosis of the hip from IBJI. “Image by: BEAUTY STUDIO/Shutterstock.com“

Stages of Osteonecrosis

The earliest stages of osteonecrosis are often painless and asymptomatic. In the early stage, advanced MRI imaging is required to appropriately identify and assess. Dr. Ackerman explains, “Similar to a sink-hole that develops, early stages can go unrecognized and often only presents after collapse of the sink-hole or articular surface of the hip.” 

Treatment for Osteonecrosis

There is excellent treatment for all stages of osteonecrosis. Success rate of treatment will depend on appropriate and early diagnosis. The initial goal for these patients is to stop disease progression and reverse the initial damage.

“While, there is no specific medication approved for osteonecrosis, there is exciting research with the use of osteoporosis, bone-stimulating medications. There is surgical treatment which involves precise drilling into the area of the femoral head to restore blood flow. The patient’s own stem cells and growth factors, taken from the nearby pelvis bone, can be delivered to the site of damage to successfully heal early stages of disease. Late stages of the disease with collapse of the femoral head are successfully managed with minimally invasive hip replacement surgery,” says Dr. Ackerman.

Each individual’s disease can progress at a different rate, and unfortunately predicting prognosis is still difficult and uncertain. Seeking treatment from an osteonecrosis hip expert can provide you the options to successfully manage this painful and debilitating condition.

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Hip Care and Treatment at IBJI

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