Pune’s Leading AVN Treatment Centre
Explore specialized treatment options and compassionate care tailored to your needs. Our expert team provides holistic support for individuals battling avascular necrosis, guiding you toward healing and improved quality of life through effective AVN disease treatment. Take the first step towards relief with our comprehensive AVN treatment plans designed to address your condition.
What is Avascular Necrosis (AVN) or Osteonecrosis (ON)?
Avascular Necrosis (AVN), also known as Osteonecrosis (ON), is the death of bone tissue due to a lack of blood supply, resulting in the deterioration of the bone. This condition primarily affects weight-bearing joints, including the hip, knee, shoulder, and ankle. AVN can develop from various causes, such as traumatic injuries, long-term corticosteroid use, excessive alcohol intake, or underlying medical conditions like sickle cell disease or lupus. Early diagnosis and treatment are essential for AVN to prevent further damage and maintain joint function.
Symptoms of Avascular Necrosis (AVN) or Osteonecrosis (ON)
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Increasing joint pain
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Reduced range of motion
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Stiffness, particularly after periods of rest
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Swelling and tenderness
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Difficulty bearing weight
Causes
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Traumatic injury to a bone or joint
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Long-term or high-dose use of corticosteroids
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Excessive alcohol intake
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Blood vessel disorders that impact blood supply to the bone
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Medical conditions such as sickle cell disease, lupus, or HIV
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Radiation therapy
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Joint decompression (e.g., following a fracture or dislocation)
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Certain medications or treatments that affect blood flow to the bone
Understanding Avascular Necrosis: How it Affects the Hip, Knee, Shoulder, and Ankle
​Avascular Necrosis of the Hip
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Avascular necrosis (AVN), also known as osteonecrosis, is a condition characterized by the death of bone tissue due to a lack of blood supply. When AVN affects the hip joint, it can lead to pain, stiffness, and difficulty walking. Effective treatment of AVN hip often involves a combination of non-surgical methods, such as physical therapy and medications, as well as surgical options like core decompression or joint replacement if the condition progresses.
Avascular Necrosis of the Knee
The knee joint is particularly vulnerable to avascular necrosis, especially after trauma or prolonged corticosteroid use. Disruption of blood flow to the knee bones can result in deterioration of the bone and cartilage damage, leading to pain and impaired mobility. Early intervention through avascular necrosis therapy, including medications and lifestyle modifications, can help manage symptoms and slow disease progression.
Avascular Necrosis of the Shoulder
Although less common than in other joints, avascular necrosis can affect the shoulder, causing discomfort and limited range of motion. Understanding shoulder AVN's risk factors and symptoms is crucial for early detection and intervention. Treatment options may include aseptic necrosis treatment strategies such as physical therapy and medications aimed at alleviating pain and improving function.
Avascular Necrosis of the Ankle
The ankle joint can also be susceptible to avascular necrosis, particularly following traumatic injuries or excessive steroid use. If left untreated, AVN of the ankle can lead to joint degeneration and significant functional impairment. Comprehensive treatment of AVN, including both conservative measures and surgical interventions when necessary, is essential to prevent further damage and restore mobility.
Diagnosis of Avascular Necrosis (AVN) or Osteonecrosis (ON)
Medical history review
Our healthcare providers conduct in-depth interviews to understand your symptoms and assess potential risk factors. We carefully evaluate prior joint trauma, corticosteroid use, alcohol consumption, and any underlying medical conditions to create a comprehensive clinical profile.
Physical examination
A thorough physical examination of the affected joint is performed to check for tenderness, assess range of motion, and identify signs of instability. Our providers also look for any neurological deficits or vascular issues in the affected limb to assist in the diagnostic process.
Advanced imaging studies
We employ state-of-the-art imaging technologies to visualize bone structures and soft tissues in exceptional detail.
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X-rays: Initial imaging used to identify changes in bone structure that may indicate AVN.
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MRI (Magnetic Resonance Imaging): Highly sensitive for detecting early signs of AVN, including bone marrow edema and necrosis.
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CT (Computed Tomography) Scan: Offers a detailed evaluation of bone anatomy and the extent of involvement, particularly in advanced cases.
Laboratory tests
Blood tests may be performed to assess underlying medical conditions associated with AVN. Evaluating blood coagulation, lipid levels, and other parameters helps identify predisposing factors contributing to AVN development.
Bone biopsy (Rarely)
In select cases where the diagnosis is difficult or malignancy is suspected, a bone biopsy may be conducted to obtain a tissue sample for histological analysis, ensuring an accurate diagnosis and appropriate management.
Clinical evaluation
Our diagnosis of AVN is based on a comprehensive analysis of clinical findings, imaging studies, and laboratory tests. This holistic approach allows us to provide precise diagnoses and develop tailored treatment plans for each patient.
Consultation with specialists
Our multidisciplinary team works closely together to deliver comprehensive care. Depending on the case's complexity, we may recommend consultations with orthopedic surgeons, rheumatologists, or hematologists to optimize patient management and outcomes.
Treatment For AVN/ON For Stages 1,2,3 & 4
Stage 1
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In the early stages of avascular necrosis (AVN), treatment focuses on preserving joint function and preventing further bone damage.
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Conservative management may involve modifying activities, ensuring adequate rest, and managing pain with nonsteroidal anti-inflammatory drugs (NSAIDs).
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Physical therapy can help maintain joint mobility and strengthen the surrounding muscles, reducing stress on the affected joint.
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In some cases, core decompression surgery may be considered to relieve pressure within the bone and stimulate the growth of new blood vessels.
Stage 2
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Treatment options for stage 2 AVN include those mentioned for stage 1 but with a greater emphasis on surgical interventions.
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Core decompression combined with bone grafting may be performed to alleviate pressure within the bone and encourage new bone formation.
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Another surgical option is vascularized bone grafting, in which healthy bone tissue and its blood supply are transplanted into the necrotic area to promote healing.
Stage 3
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In stage 3 AVN, where significant bone collapse has occurred, more aggressive surgical interventions are often required.
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Joint-preserving procedures such as osteotomy may be performed to realign the affected joint and redistribute weight-bearing forces.
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Total joint replacement (arthroplasty) may be recommended for advanced cases where conservative treatments and joint-preserving surgeries are no longer effective in alleviating symptoms and maintaining joint function.
Stage 4
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Treatment for stage 4 AVN primarily focuses on pain management and enhancing quality of life due to advanced joint destruction.
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Total joint replacement (arthroplasty) remains the primary treatment option for relieving pain and restoring function in severely affected joints.
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If joint replacement is not feasible or advisable for medical reasons, palliative measures such as pain medication and assistive devices may be used to manage symptoms and improve mobility.
Dr. Surendra Patil
(M.B.B.S DNB / D.Ortho)
Dr. Surendra Patil, MBBS, Diploma in Orthopaedics, and DNB in Orthopedic Surgery, is a highly skilled and dynamic surgeon with extensive expertise in various orthopedic surgical procedures. He is particularly proficient in arthroscopic surgeries, adult Joint Replacement, trauma management, joint replacement, and healthcare management. With over 27 years of experience in the hospital and healthcare industry, he has established himself as an accomplished medical professional known for his thorough knowledge in his field.
