Hip Pain: What is Avascular Necrosis (Osteonecrosis)?

As an orthopedic surgeon, I specialize in conditions of the hip. One disease, avascular necrosis (AVN), most commonly affects the hip joint, and can cause pain and other disorders to develop. If you or a family member received a diagnosis of AVN, you probably want to know more. In this blog, I will answer basic questions about the causes and treatments of this condition.

What is AVN?

Avascular necrosis, also known as osteonecrosis or aseptic necrosis, is a condition where the blood flow to an area of bone is compromised. It can occur in multiple areas in the body, but the most common site is in the femoral head (ball of the hip joint). The loss of blood flow leads to death (necrosis) of portions of the femoral head. The bone weakens after it dies, and can collapse over time.

What causes AVN?

In some cases, there is an identifiable risk factor or cause of AVN, but it may occur without any obvious reason (idiopathic). The most common risk factors include:

  • Steroids
  • Alcohol
  • Sickle cell disease
  • Trauma

What are the symptoms of AVN?

AVN often presents no symptoms at first, but when they occur, the common symptoms of AVN are similar to arthritis and can include:

  • Pain, often in the groin or buttock
  • Stiffness of the hip joint

What are the treatment options for AVN?

Depending on multiple contributing factors, AVN can be treated with or without surgery. Conservative (non-operative) treatment can include:

  • Observation
  • Restricted weight bearing
  • Anti-inflammatory medications
  • Bisphosphonates

Surgical treatment is dependent on the extent of the disease and can include:

Where can I learn more?

For more information, visit the American Academy of Orthopaedic Surgeons.

Scott A. Wingerter, M.D., Ph.D.About the Author: Scott A. Wingerter, M.D., Ph.D. is a board-certified and fellowship-trained orthopedic surgeon specializing in joint preservation and replacement surgery. His focus is on total joint replacement of the hip and knee, hip resurfacing, partial knee replacement, minimally invasive surgery, and hip arthroscopy.


The medical information contained in the Dickson-Diveley Orthopaedics website is provided to increase your knowledge and understanding of orthopedic conditions. This information should not be interpreted as a recommendation for a specific medical or surgical treatment plan. As each patient may have specific symptoms or associated problems, the treatment regimen for a specific patient may not be the proper treatment for another.

Gaining knowledge and understanding of a particular problem or condition is the first step in any medical treatment plan. I believe the information presented on our website will be helpful for those individuals experiencing hip pain or other related problems. However, this information is not intended to replace the advice of your family physician. You are encouraged to consult with your physician to discuss any course of treatment presented or suggested.