Hip replacement does not technically "cure" avascular necrosis, but it effectively eliminates the symptoms and restores normal hip function in advanced cases. Avascular necrosis (AVN), also known as osteonecrosis, is a condition where bone tissue dies due to lack of blood supply.

While hip replacement surgery cannot regenerate the dead bone tissue or restore the original blood supply, it provides a definitive solution by replacing the damaged bone and cartilage with artificial components, effectively eliminating pain and restoring mobility.

Understanding AVN

Avascular necrosis occurs when blood flow to the femoral head (the ball-shaped top of the thigh bone) is disrupted, causing bone cells to die and eventually leading to collapse of the joint surface. Several factors contribute to AVN:

  • Excessive alcohol consumption
  • Long-term corticosteroid use
  • Trauma or injury to the hip
  • Sickle cell disease
  • Autoimmune diseases requiring steroid treatment

Stages of AVN and Treatment Approaches

Avascular necrosis progresses through distinct stages, and the treatment approach varies based on the stage at diagnosis:

  • Stages I & II (Early): May respond to joint-preserving treatments — activity modification, NSAIDs, bisphosphonate therapy, and minimally invasive procedures.
  • Stages III & IV (Advanced): Collapse of the femoral head typically requires hip replacement surgery for optimal outcomes.

Hip Preservation First

Before considering hip replacement, hip preservation surgery offers options for early-to-mid stage AVN. Dr. Gourineni's approach uses bisphosphonate injection therapy and other preservation techniques to protect the femoral head from deformation in early stages.