Aseptic necrosis of the hip is the death of bone tissue in the head of the femur (thigh bone) due to poor blood supply.
There is a certain type of aseptic necrosis of the hip called
disease. It affects the growth plate at the upper end of the femur in children. It is most common in boys aged 5-10 years old.
The Hip Joint
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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.
Symptoms may include: Groin pain, mainly with weight-bearing actionsHip pain or limited hip motionButtock, thigh, and knee painLimping
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: X-rayCT scan
bone scanMRI scan
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 slow disease progression.
The following medications may be advised: Nonsteroidal anti-inflammatory drugs, such as ibuprofen, to relieve painBisphosphonates to prevent the loss of bone massIloprost to relax blood vesselsEnoxaparin to prevent blood clots
There are several surgical surgeries 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: Minimize the dose and duration of cortisone-like drugs.Avoid decompression disease when diving underwater.Reduce or stop smoking.Avoid excessive alcohol.
Abeles M, Urman JD, Rothfield NF. Aseptic necrosis of bone in systemic lupus erythematosus. Relationship to glucocorticoid therapy.
Arch Intern Med. 1978;138:750.
Agarwala S, Jain D, Joshi VR, Sule A. Efficacy of alendronate, a bisphosphonate, in the treatment of AVN of the hip. A prospective open-label study.
Martin K, Lawson-Ayayi S, Miremont-Salame G, et al. Symptomatic bone disorders in HIV-infected patients: incidence in the Aquitaine cohort (1999-2002).
HIV Med. 2004;5:421.
Matsuo K, Hirohata T, Sugioka Y, et al. Influence of alcohol intake, cigarette smoking, and occupational status on idiopathic osteonecrosis of the femoral head.
Clin Orthop. 1988;234:115.
Metselaar HJ, van Steenberge EJ, Bijnen AB. Incidence of osteonecrosis after renal transplantation.
Acta Orthop Scand. 1985;56:413.
Last reviewed February 2016 by Warren A. Bodine, DO, CAQSM
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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