Osteonecrosis of the Hip

Osteonecrosis of the hip is a disease that happens when blood flow to the bones in the hip joint is cut off. This causes the bone to die. And over time, the damaged joint may collapse.

The cause of osteonecrosis is not always known, but certain things can increase your risk of getting osteonecrosis of the hip. These include:

• Having a past injury to the hip such as a fracture
• Using corticosteroids for a long time. You might take these medicines for conditions like asthma or arthritis.
• Having chemotherapy or radiation treatment
• Drinking too much alcohol over a long time, or
• Having another disease such as Gaucher disease, pancreatitis, or sickle cell anemia

Osteonecrosis can cause severe pain in your hip or groin. You may not be able to move your hip very much because of the pain. Pain is worse when you put weight on the joint.

Because of the joint pain, the disease can feel a lot like arthritis, but it is not. Arthritis is caused by wear and tear on a joint, or by inflammation. Osteonecrosis is also called avascular necrosis. It is most common in the hip. But it can occur in other joints in your body, too.

Diagnosis

Your doctor can usually diagnose osteonecrosis of the hip with an X-ray. In some cases, you may need an MRI, a bone scan, or another imaging test.

You may also need a bone biopsy. The doctor will remove tissue from the affected bone and send to the lab to be looked at.

Treatment

In early stages of the disease, you may get relief from medicines that reduce pain and swelling. You may need to use a cane, crutches, or a walker to help take the weight off your hip.

Eventually, you will probably need to have surgery on your hip joint. This is to help keep the joint from breaking down.

One type of surgery for osteonecrosis is called core decompression surgery. In this procedure, the surgeon drills one large hole or several smaller holes into the bone to help blood flow better through the joint.

Another type of surgery is a bone graft. In a bone graft, the surgeon takes healthy bone and the blood vessels that supply it from elsewhere in your body. The surgeon transplants them into the hip joint.

The last option is a total joint replacement. In this procedure, the surgeon replaces the diseased hip joint with artificial parts.

Recovery from surgery to treat osteonecrosis can take several months.

Things to remember

• Osteonecrosis of the hip is caused by a problem with blood flow to the bones in the hip joint.
• At first, medicines may help relieve pain, but eventually, you'll probably need surgery.
• Recovery from surgery to treat osteonecrosis can take several months.

What we have learned

Osteonecrosis is a form of arthritis. True or False? The answer is false. Although the symptoms feel like arthritis, osteonecrosis is caused by poor blood flow to the bone. Arthritis is a disease of wear and tear, or it involves inflammation of the joint.

A total joint replacement is one way to treat osteonecrosis of the hip. True or False? The answer is true. Although medicine can help relieve pain in the short term, you will eventually need a joint replacement or another type of surgery.

Alcoholism or chronic alcohol abuse can put you at risk for osteonecrosis of the hip. True or False? The answer is true. Drinking too much alcohol can cause blood flow problems to the bone.