Aseptic Necrosis of the Hip
(Osteonecrosis; Avascular Necrosis; Ischemic Necrosis; Osteochondritis Dissecans)
by Ricker Polsdorfer, MD
Aseptic necrosis of the hip is the death of bone tissue in the head of the femur (thigh bone) due to an inadequate blood supply.
There is a specific type of aseptic necrosis of the hip called Legg-Calvé-Perthes disease. It affects the growth plate at the upper end of the femur in children. It most commonly affects boys aged 5-10 years old.
Aseptic necrosis of the hip is caused by any event or condition that damages the arteries that feed the head of the femur . The most common events are fractures in the upper femur and dislocations of the hip, especially developmental dysplasia of the hip. Other causes reduce the blood supply by closing off or compressing the blood vessels.
Risk Factors TOP
Factors that increase your chance of developing aseptic necrosis of the hip include:
Symptoms may include:
You will be asked about your symptoms and medical history. A physical exam will be done. You may be referred to an orthopedic surgeon.
Images may need to be taken of your internal structures, especially your bones. This can be done with:
Talk with your doctor about the best treatment plan for you. Treatment options include the following:
Your doctor or physical therapist may advise non-weight-bearing exercises to minimize disease progression.
The following medications may be prescribed:
There are several surgical procedures used to treat aseptic necrosis of the hip. The choice depends on the extent of disease and the age and health status of the patient. Bone grafts, decompression of the inside of the bone, realignment of the bone, femoral head resurfacing, and prosthetic hip replacement are some options.
To help reduce your chances of getting aseptic necrosis of the hip, take the following steps:
Family Doctor—American Academy of Family Physicians
OrthoInfo—American Academy of Orthopaedic Surgeons
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Updated July 15, 2014. Accessed March 10, 2015.
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Last reviewed March 2015 by Michael Woods, MD
Last Updated: 2/10/2014