Avascular Necrosis of the Hip

The hip joint is one of the body’s largest and most important joints. It is a ball-and-socket joint that includes the femoral head (the ball) and the acetabulum (the socket in the pelvis). The hip joint supports the body’s weight during both static (standing) and dynamic (walking or running) activities. Healthy cartilage and bone in the hip joint are essential for smooth, pain-free movement.

Avascular necrosis of the hip can arise from various causes, often related to factors that affect blood flow to the femoral head:

• Trauma: Injuries such as hip fractures or dislocations can disrupt blood supply to the femoral head.
• Steroid Medications: Long-term use of corticosteroids can interfere with the body’s ability to maintain a healthy blood supply to bones.
• Excessive Alcohol Consumption: Heavy drinking can lead to fatty deposits in blood vessels, reducing blood flow to the bones.
• Medical Conditions: Diseases like sickle cell anemia, lupus, and diabetes can increase the risk of AVN.
• Radiation Therapy: Treatments for cancer involving radiation can damage blood vessels near the hip joint.
• Blood Clots and Inflammation: Conditions that cause blood clots or inflammation can block blood supply to the bone.

Symptoms of avascular necrosis of the hip often develop gradually and may include:

• Persistent pain in the groin that can extend to the thigh or buttocks, particularly when putting weight on the affected hip
• A feeling of tightness or stiffness in the hip joint, especially after periods of inactivity
• Difficulty moving the hip joint, such as trouble with walking or performing everyday activities
• A noticeable limp when walking due to pain or weakness in the hip

Diagnosing AVN of the hip involves a comprehensive approach, including:

• Medical History and Physical Examination: A thorough assessment of symptoms, medical history, and physical examination to evaluate hip function.
• Imaging Tests: X-rays, MRI, or CT scans are used to detect changes in bone structure and identify early signs of AVN.
• Bone Scan: A specialized imaging test that can detect areas of reduced blood flow to the hip bone.

In the early stages of avascular necrosis, non-surgical treatments may help manage symptoms and slow disease progression:

• Medications: Pain relievers and anti-inflammatory drugs to manage pain and reduce inflammation.
• Physical Therapy: Exercises to improve hip mobility, strength, and stability.
• Activity Modification: Reducing weight-bearing activities and using assistive devices like crutches to alleviate pressure on the hip.
• Bisphosphonates: Medications that can help prevent bone loss.