Adam C. Young, MD
Alan C. League, MD
Albert Knuth, MD
Alejandra Rodriguez-Paez, MD
Alexander E. Michalow, MD
Alexander Gordon, MD
Alexander M. Crespo, MD
Alfonso Bello, MD
Ami Kothari, MD
Amy Jo Ptaszek, MD
Anand Vora, MD
Andrea S. Kramer, MD
Andrew J. Riff, MD
Angela R. Crowley, MD
Angelo Savino, MD
Anthony Savino, MD
Anuj S. Puppala, MD
Ari Kaz, MD
Ashraf H. Darwish, MD
Ashraf Hasan, MD
Bradley Dworsky, MD
Brian Clay, MD
Brian J. Burgess, DPM
Brian R. McCall, MD
Brian Schwartz, MD
Brian Weatherford, MD
Brooke Vanderby, MD
Bruce E. Noxon, DPM, FACFAS, FAPWCA
Bruce Summerville, MD
Bryan Waxman, MD
Bryant S. Ho, MD
Carey E. Ellis, MD
Carla Gamez, DPM
Cary R. Templin, MD
Charles L. Lettvin, MD
Charles M. Lieder, DO
Chinyoung Park, MD
Christ Pavlatos, MD
Christian Skjong, MD
Christopher C. Mahr, MD
Craig Cummins, MD
Craig Phillips, MD
Craig S. Williams, MD
Craig Westin, MD
Daniel M. Dean, MD
David Beigler, MD
David Guelich, MD
David H. Garelick, MD
David Hamming, MD
David Hoffman, MD
David M. Anderson, MD
David Norbeck, MD
David Raab, MD
David Schneider, DO
Djuro Petkovic, MD
Douglas Diekevers, DPM
Douglas Solway, DPM
E. Quinn Regan, MD
Eddie Jones Jr., MD
Edward J. Logue, MD
Elliot A. Nacke, MD
Ellis K. Nam, MD
Eric Chehab, MD
Eric L. Lee, MD
Evan A. Dougherty, MD
Garo Emerzian, DPM
Gary Shapiro, MD
Giridhar Burra, MD
Gregory Brebach, MD
Gregory J. Fahrenbach, MD
Gregory Portland, MD
Harpreet S. Basran, MD
Inbar Kirson, MD, FACOG, Diplomate ABOM
Jacob M. Babu, MD, MHA
Jalaal Shah, DO
James M. Hill, MD
James R. Bresch, MD
Jason G. Hurbanek, MD
Jason Ghodasra, MD
Jason J. Shrouder-Henry, MD
Jeffrey Ackerman, MD
Jeffrey Goldstein, MD
Jeffrey Staron, MD
Jeffrey Visotsky, MD
Jeremy Oryhon, MD
John H. Lyon, MD
Jonathan Erulkar, MD
Jordan L. Goldstein, MD
Josephine H. Mo, MD
Juan Santiago-Palma, MD
Justin Gent, MD
Justin M. LaReau, MD
Kellie Gates, MD
Kermit Muhammad, MD
Kevin Chen, MD
Kris Alden MD, PhD
Leah R. Urbanosky, MD
Leigh-Anne Tu, MD
Leon Benson, MD
Lori Siegel, MD
Lynn Gettleman Chehab, MD, MPH, Diplomate ABOM
Marc Angerame, MD
Marc Breslow, MD
Marc R. Fajardo, MD
Marie Kirincic, MD
Mark Gonzalez, MD
Mark Gross, MD
Mark Hamming, MD
Mark Mikhael, MD
Matthew L. Jimenez, MD
Mehul H. Garala, MD
Michael C. Durkin, MD
Michael Chiu, MD, FAAOS
Michael J. Corcoran, MD
Michael O'Rourke, MD
Nathan G. Wetters, MD
Nikhil K. Chokshi, MD
Paul L. Goodman, DPM, FACFAS, FAPWCA
Peter Hoepfner, MD
Peter Thadani, MD
Phillip Ludkowski, MD
Priyesh Patel, MD
Rajeev D. Puri, MD
Rhutav Parikh, MD
Richard J. Hayek, MD
Richard Noren, MD
Richard Sherman, MD
Ritesh Shah, MD
Robert J. Daley, MD
Robert J. Thorsness, MD
Roger Chams, MD
Ronak M. Patel, MD
Ryan J. Jacobs, MD
Scott Jacobsen, DPM
Sean A. Sutphen, DO
Serafin DeLeon, MD
Shivani Batra, DO
Stanford Tack, MD
Steven C. Chudik, MD
Steven G. Bardfield, MD
Steven Gross, MD
Steven Jasonowicz, DPM
Steven M. Mardjetko, MD
Steven S. Louis, MD
Steven W. Miller, DPM
Surbhi Panchal, MD
T. Andrew Ehmke, DO
Taizoon Baxamusa, MD
Teresa Sosenko, MD
Theodore Fisher, MD
Thomas Gleason, MD
Timothy J. Friedrich, DPM
Todd R. Rimington, MD
Todd Simmons, MD
Tom Antkowiak, MD, MS
Tomas Nemickas, MD
Van Stamos, MD
Wayne M. Goldstein, MD
Wesley E. Choy, MD
William P. Mosenthal, MD
William Robb, MD
William Vitello, MD

What You Need to Know About Osteonecrosis of the Hip

This article is part of the the Ultimate Guide to Hip Pain Relief.

There are many conditions and diseases that may result in hip pain. Hip pain can not only put a damper on the activities you once loved, but in some cases the underlying issue may be causing more damage than you think.

One such disease is osteonecrosis, also known as avascular necrosis (AVN). Osteonecrosis of the hip is a rare, but is a serious cause of hip pain and disability. 

IBJI recently chatted with Dr. Jeffrey Ackerman, board certified and fellowship trained orthopaedic surgeon. He is a comprehensive hip surgeon who is an expert on avascular necrosis of the hip and is one of a select group of surgeons that performs core decompression with autologous stem cell treatment for avascular necrosis. Dr. Ackerman tells us the main things that are important to know about osteonecrosis of the hip. His responses—below—have been edited and condensed for space.

What is Osteonecrosis of the Hip?

“Osteonecrosis involves an interruption to the microvascular blood supply to the femoral head, or ball of the hip joint,” says Dr. Ackerman, “Similar to cutting or blocking the roots to a tree, parts of the femoral head can begin to die. Depending on the severity, it can lead to complete destruction of the femoral head leading to severe, debilitating pain, necessitating hip replacement surgery.”

Causes of Osteonecrosis of the Hip

Common causes of osteonecrosis include:

  • Certain medication side-effects
  • Chronic alcohol use
  • Hereditary conditions
Osteonecrosis of the Hp
Learn more about osteonecrosis of the hip from IBJI. “Image by: BEAUTY STUDIO/Shutterstock.com

Stages of Osteonecrosis

The earliest stages of osteonecrosis are often painless and asymptomatic. In the early stage, advanced MRI imaging is required to appropriately identify and assess. Dr. Ackerman explains, “Similar to a sink-hole that develops, early stages can go unrecognized and often only presents after collapse of the sink-hole or articular surface of the hip.” 

Treatment for Osteonecrosis

There is excellent treatment for all stages of osteonecrosis. Success rate of treatment will depend on appropriate and early diagnosis. The initial goal for these patients is to stop disease progression and reverse the initial damage. 

“While, there is no specific medication approved for osteonecrosis, there is exciting research with the use of osteoporosis, bone-stimulating medications. There is surgical treatment which involves precise drilling into the area of the femoral head to restore blood flow. The patient’s own stem cells and growth factors, taken from the nearby pelvis bone, can be delivered to the site of damage to successfully heal early stages of disease. Late stages of the disease with collapse of the femoral head are successfully managed with minimally invasive hip replacement surgery,” says Dr. Ackerman.

Each individual’s disease can progress at a different rate, and unfortunately predicting prognosis is still difficult and uncertain. Seeking treatment from an osteonecrosis hip expert can provide you the options to successfully manage this painful and debilitating condition.

Get Relief from Your Hip Pain Today

Hip Care and Treatment at IBJI

Whether you are just starting out in your hip care journey or need a second opinion for your hip pain, IBJI’s hip surgeons are here to help provide you with the necessary care for your ailment. Get the relief you are seeking with the help of IBJI.

Request an appointment with an IBJI hip surgeon to discuss treatment options and create an individualized approach to your care.

Check out IBJI’s additional online resources for hip care to learn more about conditions and read patient testimonials.

Request an Appointment with a Hip Doctor →

*The blog is for general information and educational purposes only regarding musculoskeletal conditions. The information provided does not constitute the practice of medicine or other healthcare professional services, including the giving of medical advice, and no doctor-patient relationship is formed. Readers with musculoskeletal conditions should seek the advice of their healthcare professionals without delay for any condition they have. The use of the information is at the reader’s own risk. The content is not intended to replace diagnosis, treatment or medical advice from your treating healthcare professional.


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