Aseptic Necrosis of the Hip

Definition

Aseptic necrosis of the hip is the death of bone tissue in the head of the femur (thigh bone) due to an inadequate blood supply.

There is a specific type of aseptic necrosis of the hip called Legg-Calvé-Perthes disease. It affects the growth plate at the upper end of the femur in children. It most commonly affects boys aged 5-10 years old.

The Hip Joint
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Causes

Aseptic necrosis of the hip is caused by any event or condition that damages the arteries that feed the head of the femur . The most common events are fractures in the upper femur and dislocations of the hip, especially developmental dysplasia of the hip. Other causes reduce the blood supply by closing off or compressing the blood vessels.

Risk Factors

Factors that increase your chance of developing aseptic necrosis of the hip include:

Symptoms

Symptoms may include:

  • Groin pain, especially with weight-bearing actions
  • Hip pain or limited hip motion
  • Buttock, thigh, and knee pain
  • Limping

Diagnosis

You will be asked about your symptoms and medical history. A physical exam will be done. You may be referred to an orthopedic surgeon.

Images may need to be taken of your internal structures, especially your bones. This can be done with:

Treatment

Talk with your doctor about the best treatment plan for you. Treatment options include the following:

Physical Therapy

Your doctor or physical therapist may advise non-weight-bearing exercises to minimize disease progression.

Medications

The following medications may be prescribed:

  • Nonsteroidal anti-inflammatory drugs, such as ibuprofen, to relieve pain
  • Bisphosphonates to prevent the loss of bone mass
  • Iloprost to relax blood vessels
  • Enoxaparin to prevent blood clots

Surgery

There are several surgical procedures used to treat aseptic necrosis of the hip. The choice depends on the extent of disease and the age and health status of the patient. Bone grafts, decompression of the inside of the bone, realignment of the bone, femoral head resurfacing, and prosthetic hip replacement are some options.

Prevention

To help reduce your chances of getting aseptic necrosis of the hip, take the following steps:

  • Minimize the dose and duration of cortisone-like drugs.
  • Avoid decompression disease when diving underwater.
  • Reduce or stop smoking.
  • Avoid excessive alcohol.

Revisions

Please note, not all procedures included in this resource library are available at Allegiance Health or performed by Allegiance Health physicians.

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This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.

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