What are the treatment options for osteonecrosis (avascular necrosis)?

Avascular necrosis (or osteonecrosis) is the death of bone tissue due to a lack of blood supply. This can lead to tiny breaks in the bone and the bone's eventual collapse. Avascular necrosis most often affects the head of the thighbone (femur), but it may also affect other bones. Treatment includes:
  • Core decompression, a procedure in which a surgeon percutaneously removes part of the inner layer of the bone.
  • Injection of one's own harvested bone marrow stem cells, along with demineralized bone matrix.
  • Injection of parathyroid hormone -- PTH (1-34) followed by biphosphonates.

Nonsteroidal anti-inflammatory drugs (NSAIDs) and bisphosphonates such as Fosamax are used to relieve pain and slow down the progression of the osteonecrosis. Other treatment options include physical therapy, electrical stimulation to the affected bone, and plenty of rest. If the disease has advanced, your doctor may recommend a bone transplant, bone reshaping, or joint replacement.

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