Avascular Necrosis: Symptoms, Causes, Treatment

Bones help define the basic structure of the human body and have some far more essential functions than supporting the body, protecting softer organs, providing movement, storing fats and minerals, and supporting blood formation. Bone is a growing material which means that it keeps on breaking down and getting renewed constantly, but when the rate of renewal decreases and becomes far lesser than the breakdown rate, it gives rise to a condition known as Avascular Necrosis. It has become a topic of discussion amongst the health practitioners in recent times due to the ongoing pandemic. After the outbreak of black fungus and other fungal infections amongst the patients of COVID-19, Avascular Necrosis is a disease that has been reported amongst some coronavirus patients. 

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Let us go a little further and learn more about this condition, its symptoms, causes and some prevention tips by our expert Dr. Sachin Bhosle, Senior Consultant, Orthopedic surgery, Fortis Hospital, Mulund.

What is Avascular Necrosis?

The skeletal system is one of the most important organ systems of the body, which provides the body with its basic framework. The building block of this vital organ system, bones have protein in them, with the outer layer being covered with blood vessels and nerves. These blood vessels and nerves are responsible for supplying blood to the bones. Blood is required for the formation of bones, and as it is no longer available, it can lead to Avascular Necrosis, also known as bone death.

As the blood vessels in the hip joint are narrow and have hairpin bends, they get blocked very easily, and eventually the bone dries up and becomes dead. The joints formed with these dead bones become damaged and arthritis, which is very painful and leads to stiff joints.

Symptoms of Avascular Necrosis

By now, we are aware of the condition of Avascular Necrosis, so let us go a little further and understand the symptoms of this disease.

With hips being the most affected area due to this disease, the symptoms which tend to show up in that region are pain centred on thighs, buttocks or groin. Although this disease does not show any symptoms at an early stage, eventually, as the condition worsens, one might develop pain while putting some weight on the particular region. 

Although this disease majorly affects the hip area, in some cases, it can affect other body parts such as hands, feet, knees and shoulders as well.

Causes of Avascular Necrosis

A disease that occurs due to the disrupted, interrupted or reduced blood supply to the bones, here are certain other factors responsible for the occurrence of this disease and some contributing factors.

• Fat deposits in blood vessels- The blood flow in the vessels can be reduced due to the blockage formed by fat deposits or lipids in these blood vessels, which reduces the supply of blood to the bones.
• Joint Trauma- Caused due to some injury or dislocation of joint which might damage the nearby blood vessels, joint trauma can be another reason behind avascular necrosis.
• Medical conditions- Certain medical conditions like Gaucher's disease or sickle cell anemia can also be the cause behind diminishing the blood flow to the bones.
• Cancer Treatment- As cancer treatment involves radiations which can harm the blood vessels and weaken your bones 

Other than these causes, some risk factors can increase the risk of getting Avascular Necrosis.

• Excessive use of alcohol- Consuming alcohol and smoking for a prolonged period of time can cause the fatty acids to deposit in your blood vessels, resulting in a reduced blood supply to the bones.
• Medical treatments- There are certain medical treatments such as radiation therapy, organ transplant, and other such treatments that can lead to this disease.
• Use of steroids- High use of steroids such as prednisone which can increase the lipid levels in your blood and reduce the blood flow leading to the condition of Avascular Necrosis. 

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Treatment for Avascular Necrosis

Avascular Necrosis can be really painful and can also be the cause behind some other complications. It is essential to detect and treat this condition at an early stage. At an initial stage, this disease can be treated with mild medication or through stem cell treatment which is a medical process in which the patient’s bone marrow sample is aspirated with the help of a syringe and these bone-forming cells are isolated in the lab to multiply it into manifolds. These multiplied bone-forming cells are implanted after cleaning the dead bone out and curing the disease completely. 

In cases where the disease is detected later, a treatment option called hip replacement can be opted by the patient, which tends to last for decades and hence is an excellent long term solution. 

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