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Avascular Necrosis of the Femoral Head

Avascular necrosis (AVN) of the femoral head, what a mouthful! 

Necrosis is actually tissue death. Avascular means an interruption or lack of blood supply to the tissue. 

Avascular necrosis is tissue death at the head of the femur because of a lack of blood supply to that area. 

The head of the femur already has a decreased blood supply which puts it at an increased risk for avascular necrosis compared to other areas of the body. 

So what if I have tissue death, what does that really mean? 


                                                           Old Cemetery in London

These bony sections become very weak and can collapse. Besides making it difficult to move, it can be very painful. 

                                                           Nurse and doctor examining xray in hospital

How does avascular necrosis happen? What causes it? 

There are traumatic causes and nontraumatic causes of AVN. The most common traumatic cause is a femoral neck fracture usually as related to a fall. The most common nontraumatic causes are chronic corticosteroid and alcohol use. 

My doctor says I have AVN, what's next? 

Treatment as always, depends on the patient and their case. The earlier a diagnosis happens, the more treatment options that exist. Physical therapy can be involved at various steps of rehabilitation pre and post collapse of the bone tissue. 

Some other conservative interventions include: weight barring restrictions, targeted pharmacologic management, decreased alcohol and steroid use. Your physician will be the one to recommend the appropriate intervention for your case. 

If your bone tissue has already collapsed, you're looking at more involved procedures again based upon your specific case. Possible treatments to include core decompression, bone grafts, cellular therapies, osteotomies. These are all joint preservation. Joint reconstruction would be a joint replacement. 

Physical therapy's role is to help calm calm down irritable soft tissue. Likely the muscles surrounding the hip are very tense because they think they are protecting the joint! Some pain can come from these tight and tender muscles. 


                                                       Portrait of a happy romantic couple with coffee walking outdoors in old european city.  . 

We also help in strengthening these muscles to provide as much stability to the joint as possible. Balance and gait training are also an important part of recovery. 


Do you have AVN and wonder if you're appropriate for physical therapy? Reach out to our team today!