AVN

Friends, a few days ago, while going through a newspaper, I came across a medical condition called AVN, and frankly, I had never heard of it before. This led me to find out more about this medical condition. The findings of the same I want to share with you all.

AVN is the short form of Avascular Necrosis, which is the death of bone tissue due to a lack of blood supply. It is also called Ostenecrosis, it can lead to tiny breaks in bone and cause the bone to collapse. The process usually takes months to years.

SYMPTOMS

Some people have no symptoms in the early stages of avascular necrosis (AVN). As the condition worsens, affected joints might hurt only when putting weight on them. Eventually, you might feel the pain when you’re lying down.

Pain can be mild or severe. It usually develops gradually. Pain associated with AVN of the hip might center on the groin, thigh or buttock. Besides the hip, the shoulder, knee, hand and foot can be affected. Some people develop AVN on both sides, such as in both hips or both knees.

CAUSES

AVN occurs when blood flow to a bone is interrupted or reduced. Reduced blood supply can be caused by:

• Joint or bone trauma– An injury, such as dislocated joint, might damage blood vessels. Cancer treatments involving radiation also weaken bone and harm blood vessels
• Fatty deposits in blood vessels- The fat (lipid) can block small blood vessels. This can reduce blood flow to bones.
• Certain diseases- Medical conditions, such as sickle cell anemia and Gaucher’s disease, also can lessen blood flow to bone.
• Sometimes the cause of AVN is not brought on by trauma isn’t fully understood. Genetics combined with overuse of alcohol, certain medications and other diseases likely play a role.

RISK FACTORS

Risk factors for developing AVN include:

• Trauma– Injuries such as hip dislocation or fracture, can damage nearby blood vessels and reduce flow to bones.
• Steroid use– Use of high-dose corticosteroids, such as prednisone, is a common cause of AVN. The reason is unknown, but some experts believe that corticosteroids can increase lipid levels in the blood, reducing flow.
• Drinking too much alcohol– Having several alcoholic drinks a day for several years can cause fatty deposits to form in blood vessels.
• Bisphophonate use– long-term use of medications to increase bone density contribute to developing AVN of the jaw. This rare complication has occurred in some people treated with high dose of of these medications for cancers, such as multiple myeloma and metastatic breast cancer.
• Certain medical treatments– Radiation therapy for cancer can weaken bone. Organ transplants, especially kidney transplants, also are associated with AVN

Medical conditions associated with AVN include

• Pancreatitis
• Gaucher’s disease.
• HIV/AIDS.
• Sickle cell anemia.
• Decompression sickness, also known as divers’ disease or the bends.
• Certain types of cancer, such as leukemia.

Complications

If left untreated ,the AVN worsens. Eventually the bone can collapse. AVN also causes bone to lose its smooth shape, possibly leading to severe arthritis.

Prevention

To reduce the risk of AVN and improve general health:

• Limit alcohol– Heavy drinking is one of top risk for developing AVN.
• Keep cholesterol levels low– Tiny bits of fats are the most common substance blocking blood supply to bones.
• Monitor steroid use- Make sure your health care provider knows about your past or present use of high-dose steroids. Steroid-related bone damage appears to worsen with repeated courses of high-dose steroids.
• Don’t smoke- Smoking narrows blood vessels, which can reduce blood flow.

Treatment

Treatment options can vary depending on the severity and location of AVN.They can include medication, physical therapy, surgery, and in some cases, stem cell therapy.

Here are different types of treatment for AVN

• Medicines– These are used to control pain.
• Assistive devices– These are used to reduce weight on the bone or joint.
• Core decompression– For this surgical procedure, the inner layer of bone is removed to reduce pressure, increase blood flow, and slow or stop bone and/or joint destruction.
• Osteotomy– This procedure reshapes the bone and reduces stress on the affected area.
• Bone graft– In this procedure, healthy bone is transplanted from another part of the body into the affected area.
• Joint replacement– This surgical procedure removes and replaces an arthritic or damaged joint with an artificial joint. This may be considered only after other treatment options have failed to relieve from pain and/or disability.

Waiting for your views on this blog.

Anil Malik

Mumbai, India

17^th June 2025