Does Hip Replacement Cure Avascular Necrosis?

Can You Still Have Avascular Necrosis After Hip Replacement —

Avascular necrosis is the lack or decrease of blood supply to the hip joint causing bone and cartilage breakdown.  Those with avascular necrosis (or osteonecrosis) often times are pushed in the direction of getting a new hip to alleviate this issue.

hip replacement avascular necrosis

A hip replacement does not cure avascular necrosis but rather replaces the broken down joint caused by the lack of blood supply. Avascular necrosis is not a curable disease as this is a condition that worsens over many years. You will still technically have avascular necrosis even with your new hip.

By replacing the hip,  you are essentially providing a clean new joint to the same blood supply.   However this new joint is smooth and should give long lasting relief over the next 10-20 years.

What Causes Avascular Necrosis?

There are many conditions that can lead to avascular necrosis of the hip. Three of main causes of avascular necrosis are long terms diabetes, long term steroid usage and alcoholism. 

All lead to the eventual breakdown of the bone in the hip socket causing arthritis and eventually inability to use the hip without significant pain.  Let’s look at each separately to discuss the potential for your new hip replacement.

What is Artery Affected By Avascular Necrosis?

The artery directly affected by hip avascular necrosis is the medial femoral circumflex artery.  This artery is extremely vulnerable to outside conditions and damage to it will lead to hip arthritis and breakdown.

Is It Mandatory To Have Surgery If You Have Avascular Necrosis?

It is not mandatory to have hip replacement surgery if you have avascular necrosis by any means. However, total hip surgery will replace the worn down necrotic hip with a new joint and provide instant pain relief.

Diabetes and Avascular Necrosis of the Hip

Regarding diabetes and its connection to avascular necrosis, the issue with diabetic patients is increased sugar levels can directly affect blood flow. Those who have had diabetic issues over many years eventually end up with secondary problems including neuropathy, heart disease and possible joint disease.

Specific to the hip joint, the blood supply is maintained by one major vessel. When this one supply is affected by diabetic issues, it severely affects the hip joint and causes immediate breakdown. Over the years, your hip joint simply cannot maintain and you end up with pain and inability to use the leg.

Long Term Steroid Use Connected to Avascular Necrosis

Use of prednisone or other glucocorticoid steroids has been shown in multiple studies to have a strong connection to avascular necrosis development.  Because this is a system wide issue both hips can be affected with this overuse. 

Alcohol and its Connection to Avascular Necrosis.

Overuse of alcohol is a common connection to severe avascular necrosis of the hip. Heavy alcohol usage overtime directly affects blood vessels and in particular the blood supply to the hip ball joints.

alcohol avascular necrosis

Long term use of alcohol leads to fatty deposits to form in your blood vessels lowering blood supply to your joints.  This is called hyperlipidemia. In addition to blood vessels, fat cells can form in head of the femur and cause increased pressure further decreasing blood flow.

Simply put, your hip joint requires blood supply to maintain its normal motion and upkeep. Once that blood supply is gone, the joint begins to break down quickly and you are left with a degenerative hip joint.

The bad news is that this blood supply can never be regained for your hip joint unfortunately. The good news is that replacing with an artificial hip joint provides you a brand new joint surface to have much less pain and regained usage of your leg on that side.

Does A Hip Replacement Cure Avascular Necrosis?

The answer is a flat no. There is no cure for avascular necrosis as this is a long term disease involving blood supply which cannot be overturned with medicine or other treatments. 

It is very similar to arthritis which is a wearing away of a joint over time. This cannot be cured other than to remove that broken down joint and replace with an artificial joints.  You cannot return hip blood flow to its old capacity in this instance as this blood supply is extremely sensitive to other medical conditions.

What a hip replacement does in this circumstance is to provide a new part, similar to replacing brakes on your care. Over time the new brakes will start wearing down however you will likely get many miles out of your brakes just as you would from your new hip joint.

One thing to consider however is because of the avascular necrosis, your new hip joint will be lacking that blood supply similar to your old hip. Because of this, your new hip lifespan will not be as long as someone else may be able to have theirs last. 

The avascular necrosis not only affects your hip joint negatively but also the surrounding tissues in that region. Muscles, tendons ligaments and fascia need good blood supply to function properly so these will all be affected in some regard.

Is Walking Good For Avascular Necrosis?

For all intensive purposes, any cardiovascular activity such as walking and biking are good for avascular necrosis. Maintaining use of the hip joint is critical to allowing you to move freely. Impact activities involving jumping are not good for a new hip replacement.

How Fast Does Avascular Necrosis Progress?

Avascular necrosis progresses differently for each individual. The speed of progression depends on the number and severity of the factors listed above along with other factors.

Other factors not discussed in depth here include but are not limited to:

  • Direct Injury to the Region
  • High Blood Clotting Diseases
  • Autoimmune Diseases
  • Pancreatitis
  • Radiation Treatments

The more of the above conditions that you suffer from, the faster the potential progression of your avascular necrosis issues.

Physical Therapy Treatment After Hip Replacement From Avascular Necrosis

Because your blood supply is still limited after your new hip, a consistent physical therapy program is extremely important.  Regaining range of motion and strength quickly will give you the best chance for recovery and maintaining your new hip.  

Initiate home care PT services within days of returning home and be sure to maximize your efforts in the first few weeks.  The longer you wait to regain your mobility, the more difficult your long term use of the hip into the future.

It would be smart to continue a daily exercise regimen after receiving your new hip to maximize the gains and promote full mobility.  I would suggest dedicating 30-60 minutes per day to strengthen maintain your new hip for a lifetime of success.

Final Thoughts on Whether A Hip Replacement Can Cure Avascular Necrosis

  • Avascular Necrosis Can Not Be Cured WIth A Hip Replacement
  • A Hip Replacement Will Bring You Many Years of Pain Free Movement
  • Early Physical Therapy After Hip Replacement Becomes More Important For Those With Avascular Necrosis 
About Jeffrey Roth MPT

Owner and operator of Roth Therapy Services in Pittsburgh, PA focusing on in home rehabilitation physical therapy services.


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