Osteonecrosis




Osteonecrosis is a disease caused by reduced blood flow to bones in the joints. With too little blood, the bone starts to die and may break down. Osteonecrosis is also known as:
  • Avascular necrosis
  • Aseptic necrosis
  • Ischemic necrosis.
Osteonecrosis is most often found in the hips, knees, shoulders, and ankles. You may have osteonecrosis in one or more bones. In people with healthy bones, new bone is always replacing old bone. This process keeps bones strong and also happens when children grow or if a bone is injured. In osteonecrosis, bone breaks down faster than the body can make enough strong, new bone. If you do not get treatment, the disease worsens and the bones in the joints break down. You may not be able to bend or move the affected joint very well, and you may have pain in the joint.

Who Gets Osteonecrosis?

Osteonecrosis can occur in people of any age, but it is most common in people in their thirties, forties, and fifties.

What Causes Osteonecrosis?

Osteonecrosis is caused when the blood flow to the bone decreases, but why this happens is not always clear. Some known causes of osteonecrosis are:
  • Steroid medications
  • Alcohol use
  • Injury
  • Increased pressure inside the bone.
Risk factors for osteonecrosis are:
  • Radiation treatment
  • Chemotherapy
  • Kidney and other organ transplants.
Osteonecrosis is more common in people with illnesses such as: Osteonecrosis can also affect people for no known reason, even if they have no other health problems.

What Are the Symptoms of Osteonecrosis?

When osteonecrosis first begins, you may not have any symptoms. You may start to feel pain when you put weight on a joint with osteonecrosis. As the disease gets worse, you may have more pain and the joint may hurt even when you rest. Pain may be mild or severe.

If the bone and joint start to break down, you may have severe pain and not be able to use the joint. For instance, if you have osteonecrosis in the hip, you may not be able to walk. The time from the start of symptoms to losing use of the joint can range from months to more than a year.

How is Osteonecrosis Treated?

Treatment helps to keep bone in joints from breaking down. Without treatment, most people with the disease will have severe pain and limited movement within 2 years. To decide on the best treatment, your doctor will find out:
  • Your age
  • The stage of the disease
  • Where and how much bone has osteonecrosis
  • The cause, if known. If the cause is steroid or alcohol use, treatment may not work unless you stop using those substances.
The goals in treating osteonecrosis are:
  • To improve use of the joint.
  • To stop further damage.
  • To protect bones and joints.
For early stage disease, doctors may first order nonsurgical treatments. If they do not help, surgery may be needed.

Credit: National Institute of Health.
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