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Osteonecrosis 101: Key Info From a Houston Orthopedic Doctor

Author: Rosemary Buckle, M.D.

In a healthy body, new bone material constantly replaces old bone material. In some patients, however, this process doesn’t work like it should. Instead, bone material breaks down and does not regenerate quickly enough. Sometimes this problem develops because of reduced blood flow to the bones, a condition known as osteonecrosis.

Osteonecrosis (decreased blood flow to the bones) may occur as a result of:

  • Steroid medications
  • Alcohol abuse
  • Joint injuries
  • Certain diseases, such as arthritis, osteoporosis, HIV and cancer

While these things are known to be associated with osteonecrosis, physicians don’t know exactly what causes the disease.

Who can get osteonecrosis?

Anyone can develop osteonecrosis, but it is most common men and women in their thirties, forties and fifties. Those who are most at risk include patients who are undergoing (or have recently undergone) radiation therapy, chemotherapy, or organ transplant (especially kidney transplant).

How is osteonecrosis diagnosed?

Early on, many people are not aware they have osteonecrosis until they begin to experience pain. Joints with osteonecrosis may be painful to put weight on. This pain may be mild or severe. Once you see your doctor, she may refer perform an x-ray, MRI, CT scan, or some other test that allows her to see the bones. If treatment is needed, you may be referred to a Houston orthopedic physician.

How is osteonecrosis treated?

It’s important to seek out treatment as soon as possible, as most people with osteonecrosis will experience severe pain and limited range of motion within two years. Your Houston orthopedic doctor will take into account your age, the stage of the disease, the affected areas, and the supposed cause of the osteonecrosis. This information will inform a strategic treatment plan with the goal of improving use of the joint, preventing further damage, and protecting the remaining bone.

Osteonecrosis may be treated non-surgically (medication, reducing weight on the joint, improving range of motion, etc.). Technically, these options are not “treatments,” as they do not provide a cure. However, they may be the right option for some patients.

Most patients with osteonecrosis will need surgery. There are several types of surgery. In one approach, the surgeon reduces pressure inside the bone, allowing for more blood flow. In the second type of surgery, the bone is reshaped to reduce stress on the joint. In the third type, healthy bone is grafted onto the diseased portion. In the fourth type, the joint is replaced with an artificial one. (Learn more about hip and knee replacement.) Sometimes a combination of these surgeries might be used.

See A Houston Orthopedic Physician for an Evaluation

Are you suffering from joint pain? Schedule an appointment with a Houston orthopedic doctor at Houston Institute for Sports Medicine and Orthopedics. Call (713) 756-5546. You can also schedule your appointment online.

Please consult with your physician before undertaking any form of medical treatment or adopting any exercise program or dietary guidelines.