What is osteonecrosis? What is avascular necrosis?
One and the same.
Osteonecrosis or avascular necrosis is a rare and often very painful condition but before I explain it, I’ll explain the names. Quite simply it is a combination of two words:
osteo: bone, necrosis: dead. ‘Dead bone’:
avascular: without blood, necrosis: dead bone: Bone death in absence of blood
For simplicity sake, we’ll refer to the same conditions as osteonecrosis. How do you get osteonecrosis? Bone is normally nourished by a blood supply from which it receives oxygen and nourishment; toxins from the bone are removed. Anything that causes blood not to get to the bone, so that bones don’t get nourishment or oxygen, can cause the death of that bone.
What can cause blood not to get to the bone? Things like clots, sickle cell disease (in which cells are caught in capillaries and prevent normal blood flow), and trauma can do this.
Among the causes of osteonecrosis are:
- Steroids: It is theorized that steroids, like prednisone or prednisolone, cause osteonecrosis by altering fat metabolism. The alteration of fat metabolism causes fatty clots to form and the causation of osteonecrosis by steroids is well documented.
- Trauma is probably the largest cause of osteonecrosis.
- excess alcohol use
- nitrogen clots form when divers get the bends
- blood clotting disorders
- radiation therapy
Osteonecrosis/avascular necrosis is very painful and there are several treatments for it, including:
- Complete rest of the joint, often times for several months.
- Over the counter anti-inflammatory medications, such as ibuprofen or Aleve™
- Mildly invasive surgical option, core decompression
- core decompression with the use of stem cells
- The more invasive option of joint replacement