Bone Death Caused by Poor Blood Supply

Avascular Necrosis (AVN), sometimes referred to as Aseptic Necrosis or Osteonecrosis, is an area of bone and cartilage damage resulting from poor blood supply to that bone. Dead areas of bone do not function normally, can eventually become weakened and collapse. The femoral head of the hip joint is a bone known to be prone to AVN.

Causes of AVN include trauma to the hip, alcoholism, corticosteroid medications, sickle cell anemia, Lupus, and radiation exposure. A variety of conditions are associated with AVN. Among these are alcoholism, corticosteroid medications, sickle cell anemia, Lupus, and radiation exposure.

Hip AVN initially starts as a painless bone condition. Later, as the disease progresses and the bone weakens, pain develops, especially with weight bearing activities. Pain in the groin region can be felt with activity and hip rotation when bone collapse progresses, eventually leading to pain at rest.

Diagnosis of AVN can be made from imaging studies. In the early phases of the disease, AVN may only be visualized by MRI. As the disease advances, changes become apparent on plain X-rays and signify a more advanced stage of the disease.

The treatment of AVN is highly dependent on the stage of the disease at the time of diagnosis. Early treatment may involve a procedure may involve core decompression, where a core of bone from the involved area is drilled out and sometimes grafted with new bone. This is thought to allow a new blood supply to form with the goal of preserving the remaining bone. In later stages of the disease, significant changes to the bone and surrounding joint may require a joint replacement for treatment.

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Top-Ranked by U.S. News & World Report

Penn State Health includes the Milton S. Hershey Medical Center, ranked as one of the best orthopaedic providers in the country by U.S. News & World Report. This honor was earned because our doctors consistently deliver exceptional patient care and outcomes through their commitment to advanced treatments, translational research and provider training.

Coordinated, Specialized Care Through a Dedicated Institute

Our orthopaedic specialists work together through our dedicated Penn State Bone and Joint Institute. There, they focus on providing you with multidisciplinary, tailored care and state-of-the-art treatments and technologies. This produces the highest-quality patient outcomes. All physicians at the institute are fellowship-trained and subspecialize in additional niche areas of orthopaedics, including hip and knee joint arthroplasty, orthopedic trauma, and rheumatology. When AVN is caused by a non-orthopedic condition, our specialists work closely with referring physicians to ensure complete, streamlined treatment.

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Penn State Bone and Joint Institute is a Blue Distinction Center for Knee and Hip Replacement. This superior designation from BlueCross BlueShield is only given to health care facilities and providers that stand out for their expertise in delivering specialty knee and hip replacement care. Our surgeons specialize in a range of pain-relieving procedures, including partial knee replacement, total joint arthroplasty, joint preservation surgery and complex revision surgery. They perform more than 1,000 joint replacement procedures every year.

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We developed a special joint replacement education website [Link to: https://www.boneandjoint.psu.edu/] just for patients undergoing joint arthroplasty. The website takes you step by step through the joint replacement process. From things to consider before choosing surgery to recovery after surgery, you’ll find the information you need to help you feel confident in your decision to undergo joint replacement.

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The doctors and researchers in our Center for Orthopaedic Research and Translational Science at the Milton S. Hershey Medical Center are committed to advancing our field through scientific discovery and education. As the only academic medical center in central Pennsylvania, Hershey Medical Center is a national leader in research, in partnership with Penn State College of Medicine, and on the leading edge of new treatment options, including clinical trials.

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