Avascular necrosis of the femoral head is a condition most often found in people 30–50 years of age. There are many factors that reduce blood flow to the femoral head, although doctors are still unable to pinpoint the direct cause of the condition, and unfortunately, many experience bone deterioration as a result.

Causes and Risk Factors of Avascular Necrosis of the Femoral Head

Causes and risk factors of avascular necrosis of the femoral head include:

  • May develop on its own from an unknown cause
  • The result of an accident in which the hip joint dislocates or the hip or pelvis is fractured
  • Excessive, prolonged steroid use
  • Excessive alcohol consumption
  • Certain blood and autoimmune diseases
  • Smoking

Symptoms of Avascular Necrosis of the Femoral Head

During the early stages of the condition, patients may not present any symptoms. As the condition progresses, symptoms such as pain in the hip and groyne area may appear, which can even extend to the knee or buttocks of the affected side.

Diagnosis of Avascular Necrosis of the Femoral Head

Diagnosing avascular necrosis of the femoral head may involve:

  • Physical examination and a review of the patient’s medical history
  • X-ray of both hips, as up to 20% of patients suffering from avascular necrosis of the femoral head will have it on both sides
  • Magnetic resonance imaging (MRI)

Treatment of Avascular Necrosis of the Femoral Head

In addition to the patient's symptoms, test results from X-rays or MRIs can help differentiate between mild and severe conditions and aid in determining prognosis. For instance, if there are suspected changes in the bone marrow or pressure in the femoral head that could lead to degeneration, treatment can be targeted towards the anticipated outcome.

The treatment options are as follows:

Non-surgical treatment

Non-surgical treatment which is suitable in mild cases or if the condition is still in its early stages and the femoral head is not highly damaged. This method is intended to sustain the joint but is not intended as a complete cure. This route can involve:

  • Walking with the support of a walking aid (canes, walkers)
  • Undergoing physical therapy
  • Taking pain medication or other medications such as anti-coagulation, statins and other cholesterol-lowering medications, bone regeneration, and hormone medications

Surgical treatment.

Surgical treatment can involve:

  • Core decompression to reduce pressure in the bone
  • Hip replacement is considered when non-surgical options prove unsuccessful, meaning the pain does not subside or no improvement is seen after rehabilitation

The doctor will determine the most appropriate treatment plan based on each patient’s specific case.