Avascular Necrosis

Avascular necrosis (AVN), also known as osteonecrosis, is a condition in which bone tissue dies due to a lack of blood supply. It can occur in any bone in the body, but is most commonly seen in the hip joint. When a bone does not receive an adequate blood supply, the bone tissue may die and eventually collapse, leading to pain, disability, and joint damage.

Causes of Avascular Necrosis

Avascular necrosis (AVN) is caused by a disruption of blood flow to the bone, which leads to the death of bone tissue. The lack of blood flow may be caused by a number of factors, including:

Trauma: A sudden injury, such as a fracture or dislocation, can damage blood vessels and disrupt the blood supply to the affected bone.

Steroid use: Long-term use of corticosteroids, such as prednisone, can increase the risk of AVN. Steroids can disrupt the blood flow to bones, particularly in the hip joint.

Alcohol abuse: Heavy alcohol consumption can damage blood vessels and increase the risk of AVN, particularly in the hip joint.

Medical conditions: Certain medical conditions, such as sickle cell anemia, lupus, and HIV, can increase the risk of AVN. These conditions can cause blockages in blood vessels and reduce blood flow to the bones.

Radiation therapy: Radiation therapy can damage bone tissue and disrupt blood flow, increasing the risk of AVN. This is particularly true when radiation is used to treat cancers in the hip or pelvis.

It is important to note that the causes of AVN are not fully understood, and some cases may have no apparent cause. Early diagnosis and treatment of AVN can improve outcomes and prevent further damage to the affected joint.

Signs and Symptoms of Avascular Necrosis

The signs and symptoms of avascular necrosis (AVN) can vary depending on the location and severity of the condition. Common signs and symptoms include:

• Pain: The most common symptom of AVN is pain, which may be mild or severe. The pain is often located in the affected joint, and may be worsened by activity or weight-bearing.
• Stiffness: AVN can cause stiffness in the affected joint, making it difficult to move the joint through its full range of motion.
• Joint instability: In advanced cases of AVN, the affected bone may collapse, leading to joint instability and disability.
• Limited range of motion: AVN can cause a limited range of motion in the affected joint, making it difficult to perform everyday tasks.
• Muscle weakness: Muscle weakness may develop in the affected area due to reduced use or disuse of the joint.

It is important to note that not all people with AVN experience symptoms, particularly in the early stages of the condition. If you are experiencing joint pain or stiffness, it is important to seek medical attention to determine the underlying cause of your symptoms. Early diagnosis and treatment of AVN can improve outcomes and prevent further damage to the affected joint.

Treatment for Avascular Necrosis

Physiotherapy can play an important role in the treatment of avascular necrosis (AVN) by helping to manage pain, improve joint mobility, and strengthen the muscles around the affected joint. The goals of physiotherapy for AVN may include:

Pain management: Physiotherapy can help to reduce pain in the affected joint through the use of modalities such as heat, ice, and electrical stimulation.

Joint mobility: Physiotherapy can help to improve joint mobility by using techniques such as range-of-motion exercises and stretching.

Muscle strengthening: Physiotherapy can help to strengthen the muscles around the affected joint to improve joint stability and function.

Functional training: Physiotherapy can help to improve functional abilities by using exercises that simulate daily activities and sports.

Education and self-management: Physiotherapy can educate patients about the condition and how to manage symptoms, as well as provide guidance on self-management strategies such as exercise and lifestyle modifications.

It is important to note that physiotherapy should be individualized based on the patient’s specific needs and goals. A physiotherapist will work with the patient to develop a treatment plan that is tailored to their unique needs and takes into account their overall health and fitness level. Early intervention and a comprehensive rehabilitation program can improve outcomes and prevent further damage to the affected joint.

If you have any questions or would like to speak to a therapist about avascular necrosis please call us at 03 9836 1126.

Reference:

Patel, R. M., Benner, R. W., & McAndrew, C. M. (2019). Rehabilitation for Avascular Necrosis of the Hip: A Systematic Review. PM&R