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Avascular necrosis (osteonecrosis)

Osteonecrosis capitis femoris · Avaskulární nekróza (osteonekróza)

What it is

Bone dies when its blood supply fails — most often the head of the femur, after steroids, alcohol, a fracture or sickle cell disease — and then collapses.

Symptoms & signs

  • Groin or buttock pain, worse on walking
  • pain at rest and at night later on
  • stiffness and a limp
  • reduced hip rotation

🚩 Get help if…

  • call 112 / 911 now Sudden severe hip pain with fever in sickle cell disease
  • see a doctor soon Groin or hip pain after steroids, heavy drinking or a hip fracture
  • see a doctor soon Pain at rest or at night
  • see a doctor soon Limp or cannot bear weight on the leg

Where it strikes

Medical treatment

  • MRI, which shows it before an X-ray does
  • stop steroids and alcohol where possible
  • crutches to unload the hip
  • core decompression in early stages
  • hip replacement after collapse

Natural & lifestyle

  • No smoking or alcohol
  • stay active within pain
  • enough vitamin D and calcium

Emerging & experimental

  • Bone-marrow stem cells injected into the core
  • bisphosphonates to delay collapse
  • vascularised bone grafts

Alternative, off-label & anecdotal

Approaches used outside the guidelines, with what their supporters report and what testing has found so far.

  • Hyperbaric oxygen — small trials in early femoral-head necrosis early / small studies
  • Pulsed electromagnetic fields — small studies slow progression early / small studies
  • Statins alongside steroids — observational data suggest less necrosis; unproven mixed evidence

ICD codes