Avascular necrosis is a disease resulting from the temporary or permanent loss of the blood supply to the bones. Without blood, the bone tissue dies and causes the bone to collapse. If the process involves the bones near a joint, it often leads to collapse of the joint surface. This disease also is known as osteonecrosis, aseptic (bone) necrosis, and ischemic bone necrosis.
There are many theories about what causes avascular necrosis. Proposed risk factors include alcoholism, excessive steroid use, post trauma , caisson disease (decompression sickness), vascular compression, hypertension, vasculitis, thrombosis, damage from radiation, bisphosphonates (particularly the mandible) , sickle cell anaemia, and Gaucher's Disease. In some cases it is idiopathic (no cause is found). Rheumatoid arthritis and lupus are also common causes of AVN.
The treatment would be total knee replacement surgery. Some doctors also prescribe bisphosphonates (e.g. alendronate) which reduces the rate of bone breakdown by osteoclasts, thus preventing collapse (specifically of the hip) due to AVN.
Other treatments include Core Decompression & by transplanting nucleated cells from bone marrow into avascular necrosis lesions after core decompression, although more research is needed to establish this technique.
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