Femoral head AVN concept and treatments (ORP-16)

Document Type : Oral Presentation


Orthopedic Subspecialty Research Centre (OSRC), Sina University Hospital, Tehran University of Medical Sciences, Tehran, Iran


Avascular necrosis(AVN), which is known as osteonecrosis, ischemic bone necrosis, or aseptic necrosis, is a condition that results in the destruction of bone cells.
This ischemic disease, which more commonly has an effect on the femoral head and hip joint, is more prevalent in middle age and the elderly, but it is estimated that in the future, it will involve all ages. Furthermore, the conquering population in this disease is females.
Femoral head AVN is caused by a disruption in the femoral head blood flow and is popularly known as the blackening of the femoral head or hip joint(3). The alterations in the blood supply may fall out following a trauma or due to a non-traumatic event. Hip dislocation, fracture of the Femoral neck and related surgical procedures, alcohol abuse, and corticosteroid therapy frequently lead to AVN development.
Several studies show that the most common cause of AVN is corticosteroid use.
Corticosteroids as rescue drugs in treating the bulk of autoimmune diseases like MS and Behchet, pulmonary diseases like asthma, and recent covid 19 patients are the most suspected cause of this disease.
Femoral head AVN Signs and symptoms are Increasing pain and stiff joints, Limited range of motion, Limping, and  Difficulty climbing stairs, standing, or walking.
Diagnosis of AVN can be established based on history, physical examinations, and radiographic evaluations. In the primitive phases, bone scintigraphy and MRI are the favored indicative implements.   X-ray findings of AVN  in the early periods normally look regular.
Spontaneous regression of avascular necrosis is rare, and there is no agreement on the AVN therapy up to now. Non-surgical techniques are devoted to patients in the early phase of the disease and are composed of pharmacologic and physical therapy. Operation is highly recommended for patients with advanced disease.
Total Hip Arthroplasty as a prosperous surgery is the choice of treatment for patients with intolerant symptoms and high-stage involvement of the hip joint.


  • Receive Date: 30 November 2023
  • Accept Date: 30 November 2023