Medically Verified By: Dr Pankaj Walecha
Avascular Necrosis
Persistent hip pain is generally neglected by many of us, assuming it is simply due to wear and tear, or perhaps the early stage of arthritis. It could be true for some older adults who expect joint stiffness as a part of their ageing. However, relating every single joint pain to arthritis can be a dangerous mistake.
Not all joint/hip pain is associated with arthritis, but in many instances the real culprit could be an unknown and dangerous condition known as Avascular Necrosis (AVN). Understanding the difference between ordinary pain and Avascular Necrosis is important for protecting your mobility and long-term quality of life. AVN can lead to severe joint damage if not checked on time.
Dr Pankaj Walecha, Director & Head, Robotic Knee & Minimally Invasive Hip Replacement, Sarvodaya Hospital, Faridabad, describes AVN as a serious condition in which the blood supply to the bone is reduced or completely cut off, leading to bone tissue death. If left untreated, AVN can cause the hip joint to collapse, often requiring joint replacement surgery.
Reduced or completely cut-off blood supply to a specific section of bone leads to the condition AVN. Lack of blood flow to the affected bone tissue area results in the starvation and death of the bone tissues. Avascular Necrosis commonly strikes the ball portion of the hip joint located at the thigh bone and known as the femoral head, and also happens in various joints throughout the body. When AVN hits, the internal bone structure weakens and loses its strength and shape. If not treated on time, the smooth round head of the hip bone can start to break down and collapse. That leads to weakening and severe joint damage.
The tricky and dangerous thing about AVN is how quietly it starts. In the early phases, all you will feel is the mild discomfort that is easy to brush off. Avascular Necrosis generally has targeted pain. The discomfort is felt deep in the groin, buttocks, and upper thigh. The pain often kicks in during weight-bearing activities, such as walking, climbing stairs or standing for long spells. Pain becomes constant as the condition worsens, lingering even while sitting, chilling, resting, sleeping, and lying. The condition leads to worsening joint stiffness and difficulty in bending, as well as an Unnatural limp when walking.
Lifestyle, bone fractures, and certain diseases that cause problems in blood flow can lead to Avascular Necrosis. The human skeleton needs good blood flow to replace dead bone tissues with new ones. When that blood supply gets cut off, parts of the bone can start to break down. That's what leads to AVN.
Steroid Medication: A leading factor in Avascular Necrosis is the high dose or long-term use of corticosteroid medications.
Excessive Alcohol Consumption: Heavy and long-term use of alcohol can cause fatty deposits to form in the blood vessels, which blocks the blood flow to the bones.
Physical injury: Past physical injuries, especially hip injuries such as dislocations and fractures, can tear or damage delicate local blood vessels.
Pre-existing condition: Some pre-existing health conditions like sickle cell disease, autoimmune disorders, and metabolic conditions can also damage blood circulation.
Surprisingly, healthy individuals with no apparent risk factors at all can also come in its fist.
One of the initial challenges in managing Avascular Necrosis is that its early symptoms are like common muscle pain and arthritis. That leads people to often wait too long before seeking a prescription.
When you consult an orthopaedic specialist, the first test is usually an X-ray. That often doesn't show the exact condition, as in early AVN the bone hasn't changed shape yet. For catching Early-stage AVN, which is the most treatable phase, doctors use an MRI.
MRI provides a much more detailed image of soft tissues and blood flow. It can spot problems with bone tissue and blood flow long before the bone starts to collapse. That is why MRI is considered the best test for detecting AVN.
Treatment depends on the stage of the disease.
Early stage treatment
If AVN is detected in its early stage, then doctors can use a non-surgical and joint-preserving procedure to protect the bone and improve the blood flow. Restricting weight-bearing activities and using crutches to reduce pressure on the joint. Doctors use Anti-inflammatory medications and targeted physiotherapy to maintain movement or can use core decompression.
Advanced-Stage Treatment
If the condition has caused the bone collapse, then joint preservation is no longer an option. Total Hip Replacement surgery becomes necessary in these advanced cases.
Dr Pankaj Walecha says, "People should not ignore hip pain that persists for several weeks, especially if it is worsening or limiting daily activities. Seeking timely evaluation from an orthopaedic specialist can help distinguish AVN from arthritis and enable treatment before irreversible joint damage occurs. Early diagnosis remains the key to preserving joint function and maintaining long-term quality of life."
Disclaimer: This article is for general information only and is not a substitute for professional medical advice, diagnosis, or treatment. The symptoms and treatments described here may vary for each person. If you have persistent hip pain, swelling, or difficulty in movement, please consult a qualified orthopaedic specialist.
