What are the treatment options for avascular necrosis of the hip?

Avascular necrosis occurs when reduced blood supply damages bone in the femoral head. Early disease may cause pain before the joint surface changes; later disease can lead to collapse and arthritis. Imaging and examination help the orthopaedic team decide whether the aim is to protect the joint or replace a damaged joint surface.

Physiotherapy can preserve comfortable hip movement, maintain strength, and help you use walking aids correctly. Reducing impact and adjusting activity may lessen load through the hip, but these measures do not reverse established bone collapse. An osteotomy changes the alignment or loading of bone in selected situations. Total hip replacement replaces the damaged joint when pain and structural damage substantially affect function.

Follow the weight-bearing advice given by your clinician; a cane, crutches, or another aid may be recommended to reduce load. Choose low-impact movement that stays within your prescribed limits and avoid forcing painful hip rotation. Keep a record of pain, walking tolerance, night symptoms, and changes in function for appointments.

Discuss factors that may affect bone health, including steroid use, alcohol intake, smoking, and other medical conditions. Do not stop a prescribed medicine suddenly; ask the clinician who prescribed it how it should be managed.

Arrange review if hip pain is increasing, walking distance is shrinking, or you develop pain at rest or during sleep. Seek urgent care after a fall if you cannot bear weight, or if the leg appears shortened or rotated. Sudden severe pain, fever, or a hot swollen joint also needs prompt assessment.

Ask what your imaging shows, whether the joint surface is intact, and how much weight you may place through the leg. Ask why a joint-preserving procedure or replacement is being considered, what recovery involves, and how physiotherapy fits the plan.