Secondary non-traumatic avascular necrosis

Secondary non-traumatic avascular necrosis (also called secondary osteonecrosis or secondary bone necrosis) is a condition where bone tissue dies because its blood supply is cut off. Unlike traumatic avascular necrosis, which happens after an injury like a fracture, this form develops as a side effect of other medical conditions or treatments. The most common causes include long-term use of corticosteroid medications (such as prednisone), excessive alcohol use, sickle cell disease, lupus, organ transplantation, radiation therapy, and certain blood clotting disorders. The hip joint is the most frequently affected site, but it can also occur in the knee, shoulder, ankle, and other joints. When the blood supply to a bone is disrupted, the bone cells begin to die and the bone gradually weakens and may collapse. This leads to progressive joint pain, stiffness, and loss of function. Early on, there may be no symptoms at all, but as the condition worsens, pain typically increases, especially with weight-bearing activities. If left untreated, the affected joint surface can collapse, leading to severe arthritis. Treatment depends on the stage of the disease at diagnosis. Early-stage disease may be managed with medications, reduced weight-bearing, and procedures like core decompression surgery to relieve pressure inside the bone and encourage new blood vessel growth. In advanced cases where the joint surface has collapsed, joint replacement surgery (such as total hip replacement) may be necessary. Addressing the underlying cause — for example, reducing corticosteroid doses when possible — is also an important part of management.

Bring these to your next appointment

• Q1.What stage is my avascular necrosis, and what does that mean for my treatment options?,What is the underlying cause of my avascular necrosis, and can it be treated or controlled?,Am I a candidate for joint-preserving surgery like core decompression, or will I likely need a joint replacement?,Are there other joints at risk, and should I be screened with additional MRI scans?,What can I do in my daily life to slow the progression of this condition?,If I am on corticosteroids, is it possible to reduce my dose or switch to a different medication?,What physical therapy or rehabilitation program do you recommend for my situation?

Common questions about Secondary non-traumatic avascular necrosis