Aseptic Necrosis of the Hip
(Osteonecrosis of the Hip; Avascular Necrosis of the Hip; Ischemic Necrosis of the Hip; Osteochondritis Dissecans of the Hip)
by Ricker Polsdorfer, MD
Aseptic necrosis of the hip is the death of bone tissue in the head of the femur (thigh bone) due to poor blood supply.
There is a certain type of aseptic necrosis of the hip called Legg-Calvé-Perthes disease. It affects the growth plate at the upper end of the femur in children. It is most common in boys aged 5-10 years old.
Aseptic necrosis of the hip is caused by any event or condition that damages the arteries that feed the head of the femur. The most common events are fractures in the upper femur and dislocations of the hip, especially developmental dysplasia of the hip. Other causes reduce the blood supply by closing off or compressing the blood vessels.
Factors that increase your chance of getting aseptic necrosis of the hip include:
Symptoms may include:
You will be asked about your symptoms and medical history. A physical exam will be done. You may be referred to an orthopedic surgeon.
Images may need to be taken of your internal structures, especially your bones. This can be done with:
Talk with your doctor about the best treatment plan for you. Treatment options include the following:
Your doctor or physical therapist may advise non-weight-bearing exercises to slow disease progression.
The following medications may be advised:
There are several surgical surgeries used to treat aseptic necrosis of the hip. The choice depends on the extent of disease and the age and health status of the patient. Bone grafts, decompression of the inside of the bone, realignment of the bone, femoral head resurfacing, and prosthetic hip replacement are some options.
To help reduce your chances of getting aseptic necrosis of the hip, take the following steps:
Family Doctor—American Academy of Family Physicians
OrthoInfo—American Academy of Orthopaedic Surgeons
Abeles M, Urman JD, Rothfield NF. Aseptic necrosis of bone in systemic lupus erythematosus. Relationship to glucocorticoid therapy. Arch Intern Med. 1978;138:750.
Agarwala S, Jain D, Joshi VR, Sule A. Efficacy of alendronate, a bisphosphonate, in the treatment of AVN of the hip. A prospective open-label study. Rheumatology (Oxford). 2005;44:352.
Osteonecrosis of the hip in adults. EBSCO DynaMed Plus website. Available at: http://www.dynamed... . Updated December 6, 2017. Accessed February 8, 2018.
Martin K, Lawson-Ayayi S, Miremont-Salame G, et al. Symptomatic bone disorders in HIV-infected patients: incidence in the Aquitaine cohort (1999-2002). HIV Med. 2004;5:421.
Matsuo K, Hirohata T, Sugioka Y, et al. Influence of alcohol intake, cigarette smoking, and occupational status on idiopathic osteonecrosis of the femoral head. Clin Orthop. 1988;234:115.
Metselaar HJ, van Steenberge EJ, Bijnen AB. Incidence of osteonecrosis after renal transplantation. Acta Orthop Scand. 1985;56:413.
Last reviewed March 2018 by EBSCO Medical Review Board Warren A. Bodine, DO, CAQSM
Last Updated: 2/10/2014
EBSCO Information Services is fully accredited by URAC. URAC is an independent, nonprofit health care accrediting organization dedicated to promoting health care quality through accreditation, certification and commendation.
This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.
To send comments or feedback to our Editorial Team regarding the content please email us at firstname.lastname@example.org. Our Health Library Support team will respond to your email request within 2 business days.