Pune’s Leading AVN Treatment Centre
Discover specialized treatment options and compassionate care tailored to your needs. Our expert team provides holistic support for individuals battling avascular necrosis, guiding you towards healing and improved quality of life. Take the first step towards relief.
What is Avascular Necrosis (AVN) or Osteonecrosis (ON)?
Avascular Necrosis (AVN) or Osteonecrosis (ON) refers to the cellular death of bone tissue due to compromised blood supply, leading to bone deterioration. It predominantly affects load-bearing joints such as the hip, knee, shoulder, and ankle. The condition can arise from various etiologies, including traumatic injury, prolonged corticosteroid use, excessive alcohol consumption, or underlying medical conditions like sickle cell disease or lupus. Early diagnosis and treatment for AVN are crucial to prevent further damage and preserve joint function.
Symptoms of Avascular Necrosis (AVN) or Osteonecrosis (ON)
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Progressive joint pain
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Limited range of motion
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Stiffness, especially after rest
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Swelling and tenderness
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Difficulty bearing weight
Causes
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Traumatic injury to bone or joint
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Prolonged or high-dose corticosteroid use
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Excessive alcohol consumption
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Blood vessel disorders affecting the bone blood supply
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Medical conditions like sickle cell disease, lupus, or HIV
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Radiation therapy
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Joint decompression (e.g., after fracture or dislocation)
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Certain medications or treatments affecting bone blood flow
Understanding Avascular Necrosis: How it Affects the Hip, Knee, Shoulder, and Ankle
​Avascular Necrosis of the Hip
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.
Avascular Necrosis of the Knee
The knee joint is vulnerable to avascular necrosis, particularly after trauma or prolonged corticosteroid use. When blood flow to the knee bones is disrupted, it can result in bone deterioration and cartilage damage, leading to pain and impaired mobility.
Avascular Necrosis of the Shoulder
While less common than in other joints, avascular necrosis can affect the shoulder, causing discomfort and limited range of motion. Understanding the risk factors and symptoms of shoulder AVN is crucial for early detection and intervention.
Avascular Necrosis of the Ankle
The ankle joint can also be susceptible to avascular necrosis, especially following traumatic injuries or excessive steroid use. When left untreated, AVN of the ankle can lead to joint degeneration and significant functional impairment.
Diagnosis of Avascular Necrosis (AVN) or Osteonecrosis (ON)
Medical history review
Our healthcare providers conduct thorough interviews to understand your symptoms and assess potential risk factors. Prior joint trauma, corticosteroid use, alcohol consumption, and underlying medical conditions are carefully evaluated to establish a comprehensive clinical picture.
Physical examination
A meticulous physical examination of the affected joint is performed to assess for tenderness, range of motion, and signs of instability. Our providers also evaluate for any neurological deficits or vascular compromise in the affected limb to aid in the diagnostic process.
Advanced imaging studies
We utilize state-of-the-art imaging technologies to visualize bone structures and soft tissues with exceptional detail.
X-rays: Initial imaging to assess for changes in bone structure indicative of AVN.
MRI (Magnetic Resonance Imaging): Highly sensitive for detecting early signs of AVN, including bone marrow edema and necrosis.
CT (Computed Tomography) Scan: Provides detailed evaluation of bone anatomy and extent of bone involvement, especially in advanced cases.
Laboratory tests
Blood tests may be conducted to assess underlying medical conditions associated with AVN. Evaluation of blood coagulation, lipid levels, and other parameters aids in identifying predisposing factors contributing to AVN development.
Bone biopsy (Rarely)
In select cases where the diagnosis is challenging or malignancy is suspected, a bone biopsy may be performed to obtain a tissue sample for histological analysis, ensuring 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 enables us to deliver precise diagnoses and develop tailored treatment plans for each patient.
Consultation with specialists
Our multidisciplinary team collaborates closely to provide comprehensive care. Depending on the complexity of the case, consultation with orthopedic surgeons, rheumatologists, or hematologists may be recommended 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, treatment aims to preserve joint function and prevent further bone damage.
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Conservative management may include activity modification, rest, and pain management with nonsteroidal anti-inflammatory drugs (NSAIDs).
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Physical therapy can help maintain joint mobility and strengthen surrounding muscles to reduce stress on the affected joint.
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Core decompression surgery may sometimes be considered to relieve pressure within the bone and stimulate new blood vessel growth.
Stage 2
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Treatment options for stage 2 AVN may include the measures mentioned for stage 1, but with more emphasis on surgical interventions.
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Core decompression with bone grafting may be performed to reduce pressure within the bone and promote new bone formation.
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Another surgical option is vascularized bone grafting, where 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 necessary.
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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 measures and joint-preserving surgeries are no longer effective in relieving symptoms and preserving joint function.
Stage 4
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Treatment for stage 4 AVN is typically focused on pain management and improving quality of life as joint destruction is advanced.
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Total joint replacement (arthroplasty) remains the mainstay of treatment to alleviate pain and restore function in severely affected joints.
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In cases where joint replacement is not feasible or advisable due to medical reasons, palliative measures such as pain medication and assistive devices may be utilized to manage symptoms and improve mobility.
Dr. Surendra Patil
(M.B.B.S DNB / D.Ortho)
Dr. Surendra Patil, MBBS, Diploma in Orthopaedics, DNB - Orthopedics Surgery, is a dynamic surgeon with skilled hands well versed in various surgical procedures in orthopedics and exceptionally well-read in his chosen expertise. He is proficient in Arthroscopic Surgeries, Adult Joint Reconstruction Surgery, Accidents & Emergencies, Joint Replacement, Healthcare Management, and Healthcare in general. He is an experienced Medical Professional with a demonstrated history of working in the hospital & healthcare industry.
