Avascular necrosis (AVN) is the death of bone tissue due to an interruption of blood supply. When there is no blood supply, bone cannot survive. Tiny breaks develop in the bone, and if the condition is left untreated, the bone eventually collapses.
Avascular necrosis can affect anyone, but commonly occurs in individuals between the ages of 30 and 50. It often affects the hip, knee, and shoulder joints, although it can also develop in the small bones of the upper and lower extremities.
Dr. Jason Ko has special expertise treating avascular necrosis of the scaphoid bone in the wrist, and avascular necrosis of the lunate bone in the wrist, otherwise known as Kienbock’s disease. Dr. Ko also frequently treats cases of avascular necrosis of the talus bone of the ankle or the femoral head in the hip, in conjunction with his orthopedic foot and ankle surgery colleagues at Northwestern Medicine.
What Causes Avascular Necrosis?
Avascular necrosis can be caused by a few different factors. In many cases, doctors are not completely sure what causes the disease. Some known factors of avascular necrosis include bone fractures or joint dislocation that damage blood vessels and interrupt blood supply. High doses of steroid medication (e.g., Prednisone) and heavy alcohol consumption are also thought to cause or contribute to cases of avascular necrosis. Other causes include genetic factors and blood disorders, like sickle cell anemia.
Symptoms of avascular necrosis include pain, tenderness, swelling and limited motion of the affected joint. The pain may be most severe when putting weight on the affected area or at night.
If you experience persistent joint pain or tenderness that does not improve on its own or gets worse over time, you should see Dr. Ko for an evaluation. He will perform a physical examination and take your complete medical history to look for contributing factors. Imaging tests like X-rays, MRIs, or CT scans may be ordered to confirm or rule out avascular necrosis.
Treating Avascular Necrosis
If you are diagnosed with avascular necrosis of the wrist, ankle or hip bones, Dr. Ko will work with you to find the most suitable treatment to alleviate your pain or discomfort and restore function to the affected joint.
Treating avascular necrosis depends on the severity of the condition and how much damage it has caused to the affected bones.
In mild cases, it is common for Dr. Ko to prescribe rest and immobilization in a cast. He may prescribe medications to control pain and recommend the use of assistive devices to reduce weight on the affected bone or joint. Physical therapy can help to maintain or improve range of motion in the affected joint.
More serious cases can require surgery. Depending on the circumstances of the individual case, Dr. Ko may recommend any of the following treatments that he and his orthopedic colleagues at Northwestern Medicine can provide:
- Vascularized bone transfer using healthy bone from another part of the body, involving microsurgery or free flap reconstruction
- Core decompression, which removes the inner layer of the bone to reduce pain and stimulate the production of healthy bone and new blood vessels
- Osteotomy to reshape the affected bone and reduce stress on the affected area
- Joint replacement to replace damaged parts of the joint with artificial implants
Learn More from Dr. Jason Ko
Dr. Ko is the plastic and reconstructive surgeon of choice for individuals suffering from avascular necrosis and other problems affecting the upper and lower extremities. If you are experiencing pain, limited range of motion, or other symptoms that suggest a problem like avascular necrosis, Dr. Ko invites you to schedule a consultation with him today.