Avascular Necrosis (AVN) is the death of bone tissue due to a loss of blood supply. If not treated, AVN can cause the bone to collapse leading to severe morbidity. Incidence of AVN is very high following COVID 19 infection affecting young adults.

Symptoms of Avascular Necrosis
In its early stages, AVN causes pain. If the bone and surrounding joint collapses, patients suffer from severe pain that makes walking also difficult.

Causes and Risk Factors for Avascular Necrosis
Most common causes before COVID-19 infection were excessive Alcohol consumption, Cigarette smoking, Steroid usage and Trauma. Presently we are seeing patients who had COVID and steroids as the most common cause.

Impact on Society
Earning member in the family is affected and that is affecting the family financially.

Diagnosis:
AVN is diagnosed using Xray and MRI. Xray can show bone changes at later stages but MRI images will show early bone changes.

Treatment
Symptomatic pain relief can be achieved using Nonsteroidal anti-inflammatory drugs but most people with this condition eventually need surgery

Surgery
Depending on the stage of AVN there are different surgical treatments. In early stages Core decompression alone or Core decompression with fibula strut grafting is done. Recently, Core decompression with bone implantation using stem cell therapy is very successful. In late stages where the hip joint cannot be preserved, Total hip replacement by removing the damaged joint and replacing it with a synthetic joint is the best option.

Dr K J Reddy
Senior Consultant Orthopaedic Surgeon,
Apollo Hospitals, Jubilee Hills, Hyderabad.
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