Aseptic Necrosis of the Hip
Condition
(Osteonecrosis of the Hip; Avascular Necrosis of the Hip; Ischemic Necrosis of the Hip; Osteochondritis Dissecans of the Hip)
Definition
Aseptic necrosis of the hip is the death of bone tissue in the head of the thigh bone due to poor blood supply.
Legg-Calvé-Perthes disease is a type of aseptic necrosis in children. It affects the growth plate at the upper end of the thigh bone.
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Causes
Aseptic necrosis of the hip is caused by any event or health problem that blocks blood supply to the head of the thigh bone.
Risk Factors
Aseptic necrosis of the hip is more common in people who are between 30 and 50 years of age. It is also more common in men. Some things that may raise the risk are:
- Corticosteroid use
- Alcohol use disorder
- Smoking
- Hip trauma, such as hip fracture, hip dislocation, and prior hip surgery
- Cushing disease
- Sickle cell disease
- Blood clotting disorders, such as thrombophilia
- Systemic lupus erythematosus (SLE)
- HIV infection
- Kidney failure
Symptoms
There may not be symptoms of aseptic necrosis of the hip in the early stage. People who do have problems may have:
- Hip pain
- Problems moving the hip
- Groin pain and throbbing that may be worse when bearing weight
- Buttock, thigh, and knee pain
Diagnosis
The doctor will ask about symptoms and health history. A physical exam will be done.
Images may be taken of the hip. This can be done with:
Treatment
The goal of treatment is to ease symptoms and stop damage. Treatments may include:
- Limiting activities that cause pain
- Using a cane or walker to keep weight off the hip
- Physical therapy to help with strength, flexibility, and range of motion
- Avoiding or limiting alcohol and smoking
Other choices are:
Prevention
There are no guidelines to prevent aseptic necrosis of the hip.
Medication
Medicine may be given to:
- Ease pain
- Prevent loss of bone mass
- Prevent blood clots
- Improve blood flow
Family Doctor—American Academy of Family Physicians
Ortho Info—American Academy of Orthopaedic Surgeons
CANADIAN RESOURCES:
Canadian Orthopaedic Association
Health Canada
Family Doctor—American Academy of Family Physicians
Ortho Info—American Academy of Orthopaedic Surgeons
CANADIAN RESOURCES:
Canadian Orthopaedic Association
Health Canada
References
- Osteonecrosis of the hip in adults. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/osteonecrosis-of-the-hip-in-adults.
- Osteonecrosis of the hip. Ortho Info—American Academy of Orthopaedic Surgeons website. Available at: https://orthoinfo.aaos.org/en/diseases--conditions/osteonecrosis-of-the-hip.
Contributors
- Warren A. Bodine, DO, CAQSM
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