Treatment options for Avascular Necrosis (AVN)

What can be done for the condition?

Once AVN has occurred, the treatment choices are determined by how long the problem is persisting and your symptoms. While the symptoms may be reduced with pain medications and anti-inflammatory medications, no medical treatments will restore the blood supply to the femoral head and reverse the AVN.
If you are diagnosed with AVN at stage II or even III, then it is too early for a total hip replacement. Your surgeon will ask you to take medication to manage your pain; or perform core decompression. Since any of these treatment modalities do not reverse the disease, you are bound to require hip replacement in the future. Artificial hips do not restore all types of joint movements. You can only walk, sit on a chair or sofa and climb stairs. You may be refrained from routine activities like running, jogging, routine exercises like surya namaskara, sitting down of floor with crossed legs.  This artificial hip also has a life span and needs to be changed after about 10-12 years. Even there may be loosening of the attachments as a nonliving artificial part is attached to living bony structures; in which case you may require frequent interventions or revision surgeries.
Cell Based Living Drug Treatment
Physical Therapy
Surgical Intervention
Prophylactic measures
Reconstruction procedures


The surgical treatment options for AVN are Core decompression, Bone grafting, Osteotomy. Core decompression is done by removing the inner layer of bone to provide immediate pain relief by reducing pressure in the bone and decreasing inflammation. It enhances the process of creeping substitution and also encourages the formation of new blood vessels, thereby increasing blood flow to the bone. It is indicated in people with early stages of avascular necrosis, before the collapse of the head and when less than 30% of the femoral head is involved.
The preferred treatment for AVN is a core decompression with autogenous bone graft. But the supply of suitable bone is limited and its collection is painful with a risk of infection, hemorrhage, cosmetic disability, nerve damage, and a loss of function. Statin therapy, bisphosphonates or nonsteroidal anti-inflammatory drugs may be helpful as interim management, but bear a risk of progression to further advanced stage. Most patients address an orthopedic surgeon in advanced stages of the disease, after femoral head collapse. Total joint replacement is the treatment of choice in the final stages of avascular necrosis or when the joint is irreversibly destroyed.
An aging population and advance in surgical techniques have led to increased volume of regenerative orthopedic procedures. Bone regeneration by autologous bone (Osteoblast) implantation is one of the treatment concepts currently being developed, as it eliminates the problems of donor site morbidity for autogenous grafts, the immunological problems of allogenic grafts, and loosening of implants in total joint arthroplasty.
Bone marrow stem cell (BMSC) shows an osteogenic potential. They are the most potent bone regenerator with abundant cell numbers, high viability and osteogenic activities. They differentiate into Osteoblasts, adipocytes, myocytes, neuronal cells and a variety of other connective tissue.