Materiały źródłowe

• #1 Avascular necrosis (osteonecrosis) – Symptoms & causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/avascular-necrosis/symptoms-causes/syc-20369859

  Avascular necrosis is the death of bone tissue due to a lack of blood supply. Also called osteonecrosis, it can lead to tiny breaks in the bone and cause the bone to collapse. The process usually takes months to years. […] Avascular necrosis occurs when blood flow to a bone is interrupted or reduced. Reduced blood supply can be caused by: […] Joint or bone trauma. An injury, such as a dislocated joint, might damage nearby blood vessels. Cancer treatments involving radiation also can weaken bone and harm blood vessels. […] Fatty deposits in blood vessels. The fat (lipids) can block small blood vessels. This can reduce blood flow to bones. […] Certain diseases. Medical conditions, such as sickle cell anemia and Gaucher’s disease, also can lessen blood flow to bone. […] Sometimes the cause of avascular necrosis not brought on by trauma isn’t fully understood. Genetics combined with overuse of alcohol, certain medications and other diseases likely play a role.

• #2 Osteonecrosis of the Hip – OrthoInfo – AAOS

  https://orthoinfo.aaos.org/en/diseases–conditions/osteonecrosis-of-the-hip/

  Osteonecrosis of the hip is a painful condition that occurs when the blood supply to the head of the femur (thighbone) is disrupted. Because bone cells need a steady supply of blood to stay healthy, osteonecrosis can ultimately lead to destruction of the hip joint and severe arthritis. […] Osteonecrosis is also called avascular necrosis (AVN) or aseptic necrosis. Although it can occur in any bone, osteonecrosis most commonly affects the hip. More than 20,000 people each year enter hospitals for treatment of osteonecrosis of the hip. In many cases, both hips are affected by the disease. […] Osteonecrosis of the hip develops when the blood supply to the femoral head is disrupted. Without adequate nourishment, the bone in the head of the femur dies and gradually collapses. As a result, the articular cartilage covering the hip bones also collapses, leading to disabling arthritis.

• #3 Avascular Necrosis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK537007/

  Osteonecrosis is a degenerative bone condition characterized by the death of cellular components of the bone secondary to an interruption of the subchondral blood supply. Also known as avascular necrosis, it typically affects the epiphysis of long bones at weight-bearing joints. […] The widely accepted view in the literature is that a reduction in subchondral blood supply is responsible for osteonecrosis. However, numerous risk factors and theories exist on the development of this vascular impairment. […] In a small percentage of cases, mutations in the COL2A1 gene, which codes for type 2 collagen production, have demonstrated autosomal dominant inheritance patterns. However, in many cases, a cause cannot be identified, and these patients receive the designation of idiopathic osteonecrosis.

• #4 Avascular Necrosis of the Hip > Fact Sheets > Yale Medicine

  https://www.yalemedicine.org/conditions/avascular-necrosis-of-the-hip

  Avascular necrosis (AVN), also known as osteonecrosis, is the death of bone tissue caused by a disruption of blood flow within a bone. […] Avascular necrosis occurs when the blood supply within a bone in a joint is interrupted and, as a result, not enough blood (and the oxygen and nutrients it carries) reaches the affected part of a bone. This results in necrosis, or death, of bone tissue. […] When AVN occurs in the hip joint, it affects the femoral head. Blood supply to the femoral head gets disrupted, leading to the death of bone tissue. […] AVN of the hip occurs when the blood supply to the femoral head is interrupted, leading to death of bone tissue. There are two general types of AVN of the hip: traumatic and nontraumatic. […] Traumatic AVN of the hip can occur when trauma interrupts blood flow to the femoral head.

• #5 Femoral Head Avascular Necrosis: Practice Essentials, Etiology, Epidemiology

  https://emedicine.medscape.com/article/86568-overview

  Intravascular coagulation appears to be the central event associated with nontraumatic AVN. […] Coagulation may occur secondary to extravascular compression (eg, marrow fat enlargement), vessel wall injury (eg, chemotherapy, radiation), or a thromboembolic event (eg, fat emboli). […] Ischemic insult to the femoral head results in infarcted subchondral bone. In this situation, weakened and unrepaired necrotic bony trabeculae fail under a compressive load, leading to subchondral collapse (ie, crescent sign) and, ultimately, articular collapse. […] Traumatic causes of femoral head AVN include the following: Femoral neck fractures, Hip dislocation, Slipped capital femoral epiphysis. […] Atraumatic osteonecrosis causes include the following: Alcohol abuse Patients who consume less than 400 mL of alcohol per week have a 3-fold higher risk for AVN than individuals who do not drink. The risk rises to an 11-fold risk if more than 400 mL per week is consumed. […] Cases of AVN of the femoral head that developed following coronavirus disease 2019 (COVID-19) have been reported. A possible association has been suggested between the use of corticosteroids to treat patients with COVID-19 and the development of AVN.

• #6

  https://www.orthobullets.com/recon/5006/hip-osteonecrosis

  Hip Osteonecrosis, also known as avascular necrosis of the hip, represents a condition caused by reduced blood flow to the femoral head secondary to a variety of risk factors such as a traumatic event, sickle cell disease, steroid use, alcoholism, autoimmune disorders, and hypercoagulable states. […] AVN associated with trauma due to injury of femoral head blood supply (medial femoral circumflex). […] Pathophysiology idiopathic AVN intravascular coagulation is the final common idiopathic pathway. […] Coagulation of the intraosseous microcirculation, venous thrombosis, retrograde arterial occlusion, intraosseous hypertension, decreased blood flow to femoral head, AVN of femoral head, chondral fracture and collapse. […] Higher risk of AVN with greater initial displacement and poor reduction.

• #7 Avascular Necrosis/Osteonecrosis: Symptoms, Causes And Treatment

  https://www.netmeds.com/health-library/post/avascular-necrosis-osteonecrosis-symptoms-causes-and-treatment?srsltid=AfmBOorsGtM2bU8FXtnSJaNNQPFmKzNOVxMUqJXGTr5KV5uqD1UoIS9B

  Avascular necrosis is a death of bone tissue caused due to inadequate blood supply and the condition is also called osteonecrosis. […] Avascular necrosis is linked with chronic use of high dose steroid medications and excessive consumption of alcohol. […] This condition develops when the blood flow to a bone is reduced, and it can be caused due to: […] Any injury, like a dislocated joint, may damage nearby blood vessels. Cancer treatments including radiation can also weaken the bones and damage blood vessels. […] Fat deposits in the blood vessels can block small blood vessels, which reduces the blood flow to the bones. […] Certain health conditions such as sickle cell anaemia and Gauchers disease can also reduce blood flow to the bones. […] In about 25% of people, the exact cause is unknown. […] High use of steroids is one of the most common risk factors for avascular necrosis. […] Excessive consumption of alcohol can cause fatty deposits to form in the blood vessels. […] Organ transplantation, mainly kidney transplant is also linked with avascular necrosis.

• #8 Avascular necrosis (osteonecrosis) – Symptoms & causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/avascular-necrosis/symptoms-causes/syc-20369859

  Risk factors for developing avascular necrosis include: […] Trauma. Injuries, such as hip dislocation or fracture, can damage nearby blood vessels and reduce blood flow to bones. […] Steroid use. Use of high-dose corticosteroids, such as prednisone, is a common cause of avascular necrosis. The reason is unknown, but some experts believe that corticosteroids can increase lipid levels in the blood, reducing blood flow. […] Drinking too much alcohol. Having several alcoholic drinks a day for several years also can cause fatty deposits to form in blood vessels. […] Certain medical treatments. Radiation therapy for cancer can weaken bone. Organ transplants, especially kidney transplants, also are associated with avascular necrosis.

• #9 Osteonecrosis of the Hip – AAHKS

  https://hipkneeinfo.org/hip-care/osteonecrosis-of-the-hip/

  Osteonecrosis or avascular necrosis is a disease where the blood flow to the head (ball of your hip joint) of the femur is interrupted that results in a painful hip. […] Osteonecrosis can result from direct trauma to the hip, a systemic disease, or unrelated factors such as radiation. […] When the disease results from injury, it is usually confined to the injured hip. When the disease is systemic, both hips and other joints such as the shoulders may be involved. […] Most of the blood supply to the femoral head comes through the lining of the hip joint called the capsule. […] If the capsule is injured, the blood supply may be disrupted. […] Systemic causes of osteonecrosis are conditions which occur throughout the body. […] Some of the common systemic causes include steroid therapy, alcoholism, autoimmune disorders, Gauchers disease, and blood disorders.

• #10 Avascular Necrosis (Osteonecrosis): What Is It, Symptoms, Causes & Treatment

  https://my.clevelandclinic.org/health/diseases/14205-avascular-necrosis-osteonecrosis

  Avascular necrosis is a painful bone condition that gets worse over time and can affect your mobility. It occurs when something cuts off blood flow to one of your bones. Causes include broken bones, dislocated hips, radiation therapy and alcohol misuse. […] Bone fractures or disease that prevent blood flow to bone tissue causes avascular necrosis. About 20% of avascular necrosis cases happen without an obvious cause. […] Known causes of avascular necrosis are: Traumatic avascular necrosis: This can happen after you break a bone or dislocate a joint. Nontraumatic avascular necrosis: This happens if you have an illness or medical condition that keeps blood from flowing to your bone tissue. […] There are several medical conditions or treatment that can lead to avascular necrosis: Osteoporosis. Elderly women (and some men) sometimes have spontaneous avascular necrosis of the knee (SPONK). Blood disorders, such as sickle cell anemia. Diabetes. Cancer treatments, such as radiation therapy. Decompression sickness in scuba divers. HIV. Lupus. Organ transplants.

• #11 Avascular Necrosis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK537007/

  Repetitive trauma, like assembly line work, can lead to AVN over time. Nontraumatic risks for AVN include anything potentially impacting vascular flow to the bone. […] Glucocorticoids used at high doses and for prolonged periods can induce osteonecrosis via osteocyte apoptosis. […] Other risk factors for AVN are alcohol misuse, blood dyscrasias, autoimmune diseases such as lupus, etc. […] The cause of interrupted blood flow is unknown for twenty-five percent of people with AVN. […] Osteonecrosis frequently poses a diagnostic dilemma to orthopedic surgeons. Several risk factors are outlined in the literature, yet the exact pathophysiology is not fully understood. […] There are several identified risk factors for osteonecrosis, but the exact pathogenesis remains unestablished. More likely, a combination of different factors and conditions leads to the destruction of bone cells.

• #12 Osteonecrosis – Bone, Joint, and Muscle Disorders – Merck Manual Consumer Version

  https://www.merckmanuals.com/home/bone-joint-and-muscle-disorders/osteonecrosis/osteonecrosis

  Osteonecrosis is the death of a segment of bone caused by an impaired blood supply. […] Osteonecrosis is most commonly caused by an injury but can also occur without an injury. […] The most frequent cause of traumatic osteonecrosis is a displaced fracture. […] Another cause of traumatic osteonecrosis is a dislocation. […] The most common factors causing or contributing to nontraumatic osteonecrosis are use of corticosteroids (generally long-term and/or at high-doses) and excessive alcohol. […] Nontraumatic osteonecrosis occurs without direct trauma or injury. […] A number of other causes have been identified, but these occur much less often. […] In approximately 20% of people with osteonecrosis, the cause is unknown. […] Spontaneous osteonecrosis of the knee can occur in older adults who have no specific risk factors for the disorder. […] A number of disorders that are treated with high doses of corticosteroids may cause osteonecrosis.

• #13 Osteonecrosis (Avascular Necrosis) Symptoms & Causes | NIAMS

  https://www.niams.nih.gov/health-topics/osteonecrosis

  The bones of the human body are made up of living cells that need a blood supply to stay healthy. In osteonecrosis, blood flow to part of a bone is disrupted. This results in death of bone tissue, and the bone can eventually break down and the joint will collapse. Osteonecrosis is also called: […] Osteonecrosis happens when the blood supply to part of a bone is disrupted, depriving bone tissue of essential nutrients and oxygen. If the affected part of the bone is small and not subject to major weight-bearing forces, it may not cause a problem or the body’s repair processes may be able to rebuild the damaged area. But in most cases, the repair mechanisms do not work and the bone erodes or develops fractures; eventually, it may break down and collapse. […] In traumatic osteonecrosis, which develops from an injury, the loss of blood flow is likely due to damage to blood vessels. The reasons for the loss of blood supply are less clear in nontraumatic cases, but may be due to blood clots blocking the circulation or elevated pressure within the bone constricting the vessels and decreasing blood flow. […] While the underlying causes of nontraumatic osteonecrosis are not fully understood, scientists believe that genetics, along with other factors such as alcohol overconsumption, certain medications, or other diseases may play a role.

• #14 Femoral Head Avascular Necrosis: Practice Essentials, Etiology, Epidemiology

  https://emedicine.medscape.com/article/86568-overview

  Avascular necrosis (AVN) of the femoral head is a pathologic process that results from interruption of blood supply to the bone. AVN of the hip is poorly understood, but this process is the final common pathway of traumatic or nontraumatic factors that compromise the already precarious circulation of the femoral head. Femoral head ischemia results in the death of marrow and osteocytes and usually results in the collapse of the necrotic segment. […] Traumatic AVN is simply a result of mechanical disruption of blood flow to the femoral head. During sports endeavors, hip dislocation or subluxation is the most frequently reported traumatic means of AVN. […] Most cases of AVN are atraumatic and include the following: Excessive corticosteroid use and alcohol abuse account for as many as 90% of new cases.

• #15 Avascular Necrosis (Osteonecrosis): Symptoms and Causes

  https://www.theprolotherapyclinic.com/avascular-necrosis-osteonecrosis-symptoms-and-causes/

  The term avascular necrosis refers to the death of bone tissue due to a lack of blood supply. […] Injuries to joints can decrease blood flow to the area. Injury-related AVN occurs most frequently in those who have undergone surgical procedures on their joints, such as hip replacement surgery or total knee replacement surgery. […] If you are obese or have been obese in the past, there is a higher chance that you might develop this condition. […] Diabetes causes damage to blood vessels, which influences the blood supply to your bones and joints, leading to AVN. […] Overuse injuries can cause avascular necrosis. These injuries result from repeated use of a joint or bone with inadequate recovery time between activities. […] Excessive weight lifting can overwork a joints ligaments and tendons and cause a tear that impairs blood flow.

• #16 Avascular Necrosis: Practice Essentials, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/333364-overview

  Avascular necrosis (AVN) is defined as cellular death of bone components due to disruption of the subchondral blood supply. It results in pain, loss of joint function, and long-term joint damage. AVN is also known as osteonecrosis, aseptic necrosis, and ischemic bone necrosis. […] AVN is associated with numerous conditions. Corticosteroid use, sickle cell disease, and allogeneic hematopoietic stem cell transplantation and kidney transplantation are high-risk factors for AVN. […] The use of steroids is the leading cause of nontraumatic osteonecrosis. […] AVN may be primary or idiopathic. For AVN that is secondary or associated with an underlying condition or exposure, the following factors have been identified: Systemic corticosteroid use or Cushing disease – The use of high-dose corticosteroids carries a reported 3-20% incidence of AVN.

• #17 Avascular Necrosis (AVN or Osteonecrosis): Symptoms, Causes, Treatment

  https://www.webmd.com/arthritis/avascular-necrosis-osteonecrosis-symptoms-treatments

  Avascular necrosis (AVN) is the death of bone tissue due to a loss of blood supply. […] Things that can make avascular necrosis more likely include: […] Alcohol. Several drinks a day can cause fat deposits to form in your blood, which lower the blood supply to your bones. […] Steroid drugs. Long-term use of these inflammation-fighting drugs, either by mouth or in a vein, leads to 35% of all cases of nontraumatic AVN. […] Trauma. Breaking or dislocating a hip can damage nearby blood vessels and cut the blood supply to your bones. […] Blood clots, inflammation, and damage to your arteries. All of these can block blood flow to your bones. […] Other conditions associated with nontraumatic AVN include: […] Long-term use of drugs called bisphosphonates to treat cancers like multiple myeloma or breast cancer, which can lead to AVN of the jaw. […] More than half the people with this condition need surgery within 3 years of diagnosis.

• #18 Avascular Necrosis: Bone Death Symptoms, Causes, Stages, Treatments & Cure

  https://www.emedicinehealth.com/avascular_necrosis/article_em.htm

  Other risk factors for developing avascular necrosis include cigarette smoking, pregnancy, radiation and chemotherapy treatments, bone marrow and blood diseases (including sickle cell disease, leukemia, Gaucher’s disease, thalassemia), and underwater diver’s disease (from bone effects of Caisson disease, also known as dysbarism or „the bends”). […] Avascular necrosis occurs more frequently in patients with certain underlying diseases, including systemic lupus erythematosus, diabetes mellitus, vasculitis, and inflammatory bowel disease. […] It is currently suspected by some researchers that intravenous bisphosphonate medications, including zoledronate (Zometa) and pamidronate (Aredia), which are used to reduce elevated calcium levels in patients with cancer and to treat osteoporosis, may increase the risk of avascular necrosis of the jaw bone.

• #19

  https://www.orthobullets.com/recon/5006/hip-osteonecrosis

  Risk factors direct causes include irradiation, trauma, hematologic diseases (leukemia, lymphoma), dysbaric disorders (decompression sickness, „the bends”) – Caisson disease, marrow-replacing diseases (e.g. Gaucher’s disease), sickle cell disease. […] Indirect causes include alcoholism, hypercoagulable states, steroids (either endogenous or exogenous), systemic lupus erythematosus (SLE), transplant patient, virus (CMV, hepatitis, HIV, rubella, rubeola, varicella), protease inhibitors (type of HIV medication), idiopathic.

• #20 Avascular Necrosis (Osteonecrosis): What Is It, Symptoms, Causes & Treatment

  https://my.clevelandclinic.org/health/diseases/14205-avascular-necrosis-osteonecrosis

  Some lifestyle activities that increase that risk are: Excessive use of alcohol. Smoking. Prolonged corticosteroids use (prednisone). […] Treatment can slow the progress of avascular necrosis, but there is no cure. Most people who have avascular necrosis eventually have surgery, including joint replacement. People who have avascular necrosis can also develop severe osteoarthritis.

• #21 Avascular Necrosis of the Hip (AVN) – Davis Orthopedics

  https://mattdavisortho.com/avascular-necrosis-hip/

  Other medical conditions linked to AVN include sickle cell disease, lupus, diabetes, and cancer treatments like radiation therapy, which can impair blood flow to the bone. […] Excessive alcohol consumption is a leading behavioral cause, as it can lead to fatty deposits in the blood vessels, reducing circulation to the femoral head. […] Additionally, smoking constricts blood vessels, further limiting the blood supply to the bone. […] Proper staging of AVN helps in selecting the appropriate treatment plan to prevent joint collapse and alleviate pain, with early intervention providing the best chance for joint preservation. […] The prognosis for avascular necrosis (AVN) of the hip largely depends on the stage at which the condition is diagnosed and the effectiveness of treatment. […] Early diagnosis offers the best chance for positive outcomes, as interventions such as core decompression and other hip-preserving procedures can prevent or slow the progression of the disease. […] However, if AVN is diagnosed after the femoral head has begun to collapse (Stage III or IV), the prognosis worsens. […] Factors that can negatively impact the prognosis include larger areas of bone damage, delayed diagnosis, and underlying health conditions like diabetes or lupus.

• #22 Avascular Necrosis: Practice Essentials, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/333364-overview

  Trauma […] Alcohol abuse […] Systemic lupus erythematosus (with or without antiphospholipid syndrome), as well as other connective-tissue diseases […] Hemoglobinopathies or hemophilic disorders (eg, sickle cell disease, hemophilia A or B) […] Osteoporosis medications (ie, bisphosphonates, denosumab) […] Hyperlipidemia […] Bone disorders (slipped capital femoral epiphysis, congenital dysplasia of the hip, Legg-Calve-Perthes disease) […] HIV infection […] Kidney transplantation (overweight/obesity and higher cumulative corticosteroid doses are risk factors in this population) […] Allogeneic hematopietic stem cell transplantation […] Radiation therapy […] Gaucher disease […] Malignancy (marrow infiltration, malignant fibrous histiocytoma) […] Caisson disease (uncommon diving-related decompression illness) […] Pregnancy […] Psoriasis […] Inflammatory bowel disease.

• #23 Avascular Necrosis (Osteonecrosis): Treatment, Causes, and More

  https://www.healthline.com/health/avascular-necrosis-osteonecrosis

  Some less common causes of AVN include: the bends, also called decompression sickness and caisson disease, a condition caused by the rapid release of nitrogen into the blood, taking bisphosphates, such as zoledronate/zoledronic acid (Reclast, Zometa) or pamidronate to treat cancer in the bone, chemotherapy or radiation, high cholesterol, high triglycerides, or both, Gauchers disease, HIV infection, lupus, organ transplants, especially a kidney transplant, pancreatitis, sickle cell anemia or other blood disorders. […] Men develop AVN more than women unless the cause is injury or lupus. It most often affects people ages 30 to 60. But people of any age can develop AVN.

• #24 Avascular Necrosis | University Foot & Ankle Institute

  https://balancehealth.com/services/avascular-necrosis/university-foot-and-ankle-institute/

  Avascular necrosis (AVN), also known as osteonecrosis, is a serious condition that occurs when the blood supply to a bone is interrupted, leading to bone tissue death. […] Several factors can contribute to AVN, including: Trauma or Injury: Fractures or dislocations can damage blood vessels, reducing blood supply to the bone. Chronic Steroid Use: Long-term use of corticosteroids can increase the risk of AVN by affecting the body’s ability to maintain healthy bone tissue. Excessive Alcohol Consumption: Heavy alcohol intake can interfere with blood circulation and lead to bone damage. Medical Conditions: Diseases such as diabetes, lupus, sickle cell anemia, and blood clotting disorders can predispose individuals to AVN. Radiation Therapy or Chemotherapy: Cancer treatments can weaken bones and disrupt blood flow, leading to AVN.

• #24 Avascular Necrosis | University Foot & Ankle Institute

  https://balancehealth.com/services/avascular-necrosis/university-foot-and-ankle-institute/

  Avascular necrosis occurs when there is inadequate blood flow to a bone, causing bone cells to die. This leads to a weakened structure, increasing the risk of fractures and joint deterioration. […] The goal of treatment is to relieve pain, preserve bone integrity, and prevent further joint damage. Treatment options include: Non-Surgical Treatments: Medications: Nonsteroidal anti-inflammatory drugs (NSAIDs) help reduce pain and inflammation. Activity Modification: Avoiding high-impact activities to reduce stress on the affected bone. Bracing or Casting: Immobilization may slow the progression of AVN and allow partial healing. Physical Therapy: Exercises to improve strength, flexibility, and mobility. Lifestyle Changes: Reducing alcohol intake and discontinuing steroid use when possible. […] While not all cases of AVN can be prevented, the following measures can help reduce the risk: Maintain a healthy diet and exercise regularly to support bone health. Avoid excessive alcohol consumption. Use steroids only as prescribed by a healthcare provider. Manage underlying medical conditions such as diabetes and autoimmune disorders. Seek early treatment for foot and ankle injuries to prevent complications.

• #25 Osteonecrosis (ON) – Musculoskeletal and Connective Tissue Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/musculoskeletal-and-connective-tissue-disorders/osteonecrosis/osteonecrosis-on

  Osteonecrosis can be idiopathic, caused by trauma, or due to nontraumatic factors. The most common cause of osteonecrosis is trauma. […] The most common factors causing or contributing to nontraumatic osteonecrosis are corticosteroid use (particularly with prolonged use and/or higher doses) and excessive alcohol consumption. […] About 20% of cases of osteonecrosis are idiopathic. […] The contribution of corticosteroid use to the risk of osteonecrosis is increased when the dose of prednisone or an equivalent corticosteroid is 20 mg/day for several weeks or months, or the cumulative dose is 2000 mg. […] The risk of osteonecrosis is also increased when 400 mL ethanol/week are consumed for more than 6 months. […] Some genetic factors increase susceptibility to osteonecrosis. […] Medication-related osteonecrosis of the jaw has been reported in patients who have received bisphosphonate therapy (particularly with IV administration) and other antiresorptive agents. […] The term „spontaneous osteonecrosis of the knee” (SONK) is a misnomer. This condition normally occurs in older patients and is localized to the femoral condyle or tibial plateau. True osteonecrosis of the knee can result from trauma or any of the nontraumatic risk factors of osteonecrosis.

• #26 Osteonecrosis – UF Health

  https://ufhealth.org/conditions-and-treatments/osteonecrosis

  Osteonecrosis is bone death caused by poor blood supply. […] Osteonecrosis occurs when part of the bone does not get blood flow and dies. After a while, the bone can collapse. If osteonecrosis is not treated, the joint deteriorates, leading to severe arthritis. […] Osteonecrosis can be caused by disease or by severe trauma, such as a fracture or dislocation, that affects the blood supply to the bone. Osteonecrosis can also occur without trauma or disease. This is called idiopathic — meaning it occurs without any known cause. […] The following are possible causes: Using oral or intravenous steroids, Excessive alcohol use, Sickle cell disease or any blood condition that causes abnormal blood clotting, Dislocation or fractures around a joint, Clotting disorders, HIV or taking HIV drugs, Radiation therapy or chemotherapy, Gaucher disease, Systemic lupus erythematosus, Legg-Calve-Perthes disease, Decompression sickness from a lot of deep sea diving. […] When osteonecrosis occurs in the shoulder joint, it is usually due to long-term treatment with steroids, a history of trauma to the shoulder, or the person has sickle cell disease or any abnormal blood clotting conditions.

• #27 Avascular Necrosis: Symptoms, Causes, Treatment, & More! : Elite Sports Medicine + Orthopedics: Orthopedics

  https://www.eliteorthopaedic.com/blog/avascular-necrosis/

  While not all cases of avascular necrosis can be prevented, there are steps that can be taken to reduce the risk of developing the condition. […] In some cases, avascular necrosis can be cured with early diagnosis and treatment. However, in severe cases, surgery may be necessary to remove damaged bone tissue, transplant healthy bone tissue, or replace the joint. […] Avascular necrosis can occur in any bone in the body, but it most commonly affects the hips, knees, shoulders, and ankles. […] Avascular necrosis is a relatively uncommon condition, affecting about 10,000 to 20,000 people in the United States each year. However, it can be a serious and debilitating condition if left untreated. […] Treating avascular necrosis early can help slow the progress of the disease and allow you to live a more pain-free lifestyle. […] In conclusion, avascular necrosis is a serious condition that can cause significant pain and disability. Early diagnosis and treatment are essential for managing the condition and preventing further complications.

• #28 Avascular Necrosis Causes, Symptoms, and Treatment

  https://www.upmc.com/services/orthopaedics/conditions/avascular-necrosis

  Avascular necrosis (AVN) is when your bone starts to die because it isnt getting enough blood flow. […] AVN happens when a bone loses its blood supply. Without blood bringing essential nutrients, the tissue in the bone dies and, in time, the bone collapses. […] Doctors dont always know what causes AVN. But there are some things we know can reduce the blood supply to a bone. […] The reason AVN happens in the hip more than any other place is that long bones like your femur are more at risk. […] Left untreated, AVN can cause the tissue in the hip joint to die and, eventually, the bone can collapse. […] Ultimately, doctors cant cure avascular necrosis without surgery. But not everyone needs surgery immediately after diagnosis. […] You can recover from AVN, but only with surgery. Nonsurgical treatment can help manage symptoms for a while, but these treatments can’t cure it.

• #29 Avascular necrosis – Wikipedia

  https://en.wikipedia.org/wiki/Avascular_necrosis

  Avascular necrosis (AVN), also called osteonecrosis or bone infarction, is death of bone tissue due to interruption of the blood supply. […] Risk factors include bone fractures, joint dislocations, alcoholism, and the use of high-dose steroids. […] The main risk factors are bone fractures, joint dislocations, alcoholism, and the use of high-dose steroids. […] Osteonecrosis is also associated with cancer, lupus, sickle cell disease, HIV infection, Gaucher’s disease, and Caisson disease (dysbaric osteonecrosis). […] Prolonged, repeated exposure to high pressures (as experienced by commercial and military divers) has been linked to AVN, though the relationship is not well understood. […] In children, avascular osteonecrosis can have several causes. It can occur in the hip as part of Legg-Calv-Perthes syndrome, and it can also occur as a result after malignancy treatment such as acute lymphoblastic leukemia and allotransplantation.

• #30 Clinical manifestations and diagnosis of osteonecrosis (avascular necrosis of bone) – UpToDate

  https://www.uptodate.com/contents/clinical-manifestations-and-diagnosis-of-osteonecrosis-avascular-necrosis-of-bone

  Two types of osteonecrosis are limited to children: idiopathic osteonecrosis of the femoral head (Legg-Calvé-Perthes disease) and osteonecrosis related to slipped capital femoral epiphysis, usually occurring in adolescents. The differences in the natural history of adult osteonecrosis and the juvenile forms may reflect differences in the pathogenesis and natural history of these diseases.

• #30 Clinical manifestations and diagnosis of osteonecrosis (avascular necrosis of bone) – UpToDate

  https://www.uptodate.com/contents/clinical-manifestations-and-diagnosis-of-osteonecrosis-avascular-necrosis-of-bone

  Osteonecrosis, also known as aseptic necrosis, avascular necrosis (AVN), atraumatic necrosis, and ischemic necrosis, is a pathologic process that is associated with numerous conditions and therapeutic interventions. The cause is clearly identifiable in patients who have direct damage to bone vasculature (eg, femoral neck fracture) or direct injury of bone or marrow elements (eg, radiation injury, dysbarism, or decompression disease). However, in many patients, the mechanisms by which this disorder develops are not fully understood. […] Most proposed etiologies involve reduced perfusion leading to ischemia and eventual death of bone and marrow cells (bone marrow infarction) and ultimate mechanical failure. The process is most often progressive, resulting in joint destruction within a few months to several years in the majority of patients.

• #31 Osteonecrosis of the Hip – OrthoInfo – AAOS

  https://orthoinfo.aaos.org/en/diseases–conditions/osteonecrosis-of-the-hip/

  It is not always known what causes the lack of blood supply, but doctors have identified a number of risk factors that can make someone more likely to develop osteonecrosis: Injury. Hip dislocations, hip fractures, and other injuries to the hip can damage the blood vessels and impair circulation to the femoral head. […] Osteonecrosis is associated with other diseases, including Caisson disease (diver’s disease, or „the bends”), sickle cell disease, myeloproliferative disorders, Gaucher’s disease, systemic lupus erythematosus, Crohn’s disease, arterial embolism, thrombosis, and vasculitis. […] Although nonsurgical treatment options such as anti-inflammatory medications, activity changes, and using crutches can help relieve pain and slow the progression of the disease, the most successful treatment options are surgical. […] If osteonecrosis has advanced to the point where the femoral head has already collapsed, the most successful treatment is total hip replacement.

• #32 Avascular Necrosis (Osteonecrosis) of the Hip – Robert Howells

  https://roberthowells.com.au/conditions-and-treatment/avascular-necrosis-osteonecrosis-hip/

  AVN can progress through these stages quite rapidly over a period of just a few months or it may take 12 18 months. […] The treatment of avascular necrosis depends on a number of factors individual factors, how much bone is affected and most importantly the stage of the condition. […] Core Decompression is a procedure that involves the drilling of one large or several small holes into the affected area of the femoral head to relieve pressure within the bone and to create channels for new blood vessels to grow into the avascular bone in an attempt to re-establish a new blood supply. […] Unfortunately for the majority of patients diagnosed with AVN of the hip, Total Hip Replacement (THR) remains the only treatment that is able to satisfactorily deal with the damaged bone and joint surface of the femoral head.

• #33 Avascular Necrosis Lubbock, TX | Osteonecrosis Treatment Lubbock, TX

  https://www.lbkhipandknee.com/avascular-necrosis-orthopaedic-surgeon-lubbock-tx.html

  Avascular necrosis, also called osteonecrosis, is a condition in which bone death occurs because of inadequate blood supply to it. […] Chronic use of high doses of steroid medications and heavy alcohol consumption are the two main risk factors for avascular necrosis. […] Initially, small breaks appear in the bone that may eventually collapse.

• #34 Ortho Globe | Avascular Necrosis: Causes, Effects & Treatments

  https://orthoglobe.org/understanding-avascular-necrosis-causes-effects-and-treatment-options/

  Corticosteroid use: Long-term use of corticosteroid medications, often prescribed for conditions like asthma, rheumatoid arthritis, and lupus, is associated with an increased risk of osteonecrosis. […] Underlying medical conditions: Osteonecrosis has been linked to several diseases, including: Caisson disease (decompression sickness or the bends), Sickle cell disease, Myeloproliferative disorders, Gauchers disease, Systemic lupus erythematosus, Crohns disease, Arterial embolism or thrombosis, Vasculitis. […] In osteonecrosis, the bone in the head of the femur slowly dies. […] Core decompression is a surgical technique used to alleviate pressure within the femoral head. […] When performed in the early stages of osteonecrosis, core decompression can often prevent the collapse of the femoral head and reduce the likelihood of arthritis developing in the hip.

• #35 Avascular Necrosis Treatment Virginia Beach | Bone Transplant Hampton Roads, VA | Bone Reshaping

  https://www.jordan-younginstitute.com/avascular-necrosis-orthopedic-surgeon-virginia.html

  Avascular necrosis, also called osteonecrosis, is a condition in which bone death occurs because of inadequate blood supply to it. […] Chronic use of high doses of steroid medications and heavy alcohol consumption are the two main risk factors of avascular necrosis. […] Avascular necrosis can be treated by one of the following methods: […] Core decompression: During this procedure, a portion of the inner layer of the bone is removed to relieve the pressure inside the bone. […] Bone transplant: A healthy bone harvested from another part of your body is grafted into the affected area. […] Bone reshaping (osteotomy): This procedure is done in advanced stages and involves reshaping of the bone which is done to decrease the stress placed over the affected bone. […] Joint replacement: Joint replacement surgery is performed as a last resort when the bone has collapsed, needing artificial replacement.

• #36 Osteonecrosis of the Hip – OrthoInfo – AAOS

  https://orthoinfo.aaos.org/en/diseases–conditions/osteonecrosis-of-the-hip

  Although nonsurgical treatment options such as anti-inflammatory medications, activity changes, and using crutches can help relieve pain and slow the progression of the disease, the most successful treatment options are surgical. […] If osteonecrosis has advanced to the point where the femoral head has already collapsed, the most successful treatment is total hip replacement.

• #37 FAQ: Avascular Necrosis Answered Personally – NYHK

  https://www.newyorkhipknee.com/faqs/avascular-necrosis-faqs/

  The long-term heavy consumption of alcohol is a known cause of avascular necrosis (AVN) of the femurs head. Long-term alcohol consumption causes hyperlipidemia, which is the excess of fatty cells in the body. The blood levels of fat in the form of triglycerides, low-density lipoproteins (LDL), and very-low-density lipoproteins (VLDL) increase. […] A bone bruise may potentially disrupt the blood supply to the bone resulting in ischemia and necrosis. Any trauma/injury, which may result in decreased blood supply to the bone may cause avascular necrosis. […] Unfortunately, most cases of avascular necrosis progress, causing worsening of the symptoms. But rarely, in the early stages of the disease, when the avascular necrosis is caused by alcoholism or Corticosteroids, stopping the alcohol/corticosteroid may stop the progression and may heal by formation by the formation of new blood vessels.

• #37 FAQ: Avascular Necrosis Answered Personally – NYHK

  https://www.newyorkhipknee.com/faqs/avascular-necrosis-faqs/

  Avascular necrosis can be prevented by decreasing the risk factors that cause avascular necrosis in the first place. As an example, patients who are alcoholics can decrease their alcohol or eliminate the intake of alcohol. Sickle cell anemia needs to be controlled. The use of corticosteroids for treatment of asthma or systemic lupus erythematosus should be minimized. […] Avascular necrosis of the hip usually starts with a small area where the blood supply to the bone is cut off and it is usually in the weight-bearing part of the hip joint. As the disease advances, the head of the upper end of the thigh bone (femur) begins to collapse, there is formation of cysts, and eventually there is arthritis. […] Corticosteroid and ethanol are the most common drugs causing avascular necrosis. Several other medications have been found to potentially cause AVN, including adrenocorticotropic hormone therapy, anti-cancer drugs, arsenic compounds, and antiretroviral drugs like protease inhibitors.

• #38 Avascular Necrosis (Osteonecrosis) | Stanford Health Care

  https://stanfordhealthcare.org/medical-conditions/bones-joints-and-muscles/avascular-necrosis.html

  Nontraumatic avascular necrosis can result from certain medications, treatments, and lifestyle choices, including excessive alcohol use over an extended time, long-term or heavy use of corticosteroids, radiation therapy or chemotherapy treatments for cancer, and smoking. […] Many disorders, diseases, and conditions can also lead to nontraumatic avascular necrosis. Your risk is higher if you have received treatments for leukemia, Hodgkin lymphoma, or non-Hodgkin lymphoma. Your risk is also increased if you have Cushing’s syndrome, decompression sickness, disorders affecting the blood, Gaucher disease, HIV and AIDS, liver disease, chronic kidney disease, or pancreatitis, lupus, Perthes disease, or tumors on or near the bone. […] It might not be possible to prevent all types of avascular necrosis. But you can lower your risk of corticosteroid-related avascular necrosis by limiting your use of this medication. To reduce your risk of avascular necrosis as well as a range of other health problems, avoid smoking and limit the amount of alcohol you drink.

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