Osteonecrosis or Avascular Necrosis AVN Osteonecrosis is bone death caused by poor blood supply. It is most common in the hip and shoulder but can affect other large joints such as the knee, elbow, wrist, and ankle. Avascular necrosis is also known as Bone infarction; Ischemic bone necrosis; AVN; Aseptic necrosis Causes of AVN Osteonecrosis occurs when part of the bone does not get blood flow and dies. After a while, the bone can collapse. If osteonecrosis is not treated, the joint deteriorates, leading to severe arthritis. Osteonecrosis can be caused by disease or by severe trauma, such as a fracture or dislocation, that affects the blood supply to the bone. Osteonecrosis can also occur without trauma or disease. This is called idiopathic meaning it occurs without any known cause. Possible causes: Using oral or intravenous steroids Excessive alcohol use Sickle cell disease Dislocation or fractures around a joint Clotting disorders HIV or taking HIV drugs Radiation therapy or chemotherapy Gaucher disease (disease in which harmful substances build-up in certain organs and the bones) Systemic lupus erythematosus (an autoimmune disease in which the body's immune system mistakenly attacks healthy tissue such as the skin, joints, and certain organs) Legg-Calve-Perthes disease (childhood disease in which the thigh bone in the hip doesn't get enough blood, causing the bone to die) Decompression sickness from a lot of deep sea diving When osteonecrosis occurs in the shoulder joint, it is usually due to long-term treatment with steroids, a history of trauma to the shoulder, or the person has sickle cell disease. Symptoms There are no symptoms in the early stages. As bone damage worsens, you may have the following symptoms: Pain in the joint that may increase over time and becomes severe if the bone collapses Pain that occurs even at rest Limited range of motion Groin pain, if the hip joint is affected Limping, if the condition occurs in the leg Difficulty with overhead movement, if the shoulder joint is affected Worsening arthritic symptoms in the joint when the condition deteriorates. Diagnostic Exams & Tests We do a physical exam to find out if you have any diseases or conditions that may affect your bones. You will be asked about your symptoms and medical history. Be sure to let us know about any medicines or vitamin supplements you are taking, even over-the-counter medicine. After the exam, we will advise one or more of the following tests: X-ray MRI Bone scan CT scan Treatment If we knows the cause of osteonecrosis, part of the treatment will be aimed at the underlying condition. For example, if a blood clotting disorder is the cause, treatment will consist, in part, of clot-dissolving medicine. If the condition is caught early, you will take pain relievers and limit use of the affected area. This may include using crutches if your hip, knee, or ankle is affected. You may need to do range-of-motion exercises. Prolotherapy, PRP & Trigger Point Injection Therapy provides promising results in Avasular Necrosis irrespective of it's stage. It Slows Down Progress of Disease and arrests the Necrosis Process. In early stage of Disease if Prolotherapy is started improvement in Bony Structure is visible in many patients. Nonsurgical treatment can often slow the progression of osteonecrosis, but most people will need surgery. Surgical options include: A bone graft A bone graft along with its blood supply (vascularized bone graft) Removing part of the inside of the bone (core decompression) to relieve pressure and allow new blood vessels to form Cutting the bone and changing its alignment to relieve stress on the bone or joint (osteotomy) Replacing the deteriorated part with a donor osteochondral allograft Total joint replacement For more Information and Treatment contact Dr Dhanduke's Ortho Solution Way to Pain Free Life Call or What's App on 8856860463