When is total hip replacement recommended for avascular necrosis of the hip?

Avascular necrosis reduces blood supply to the femoral head, the ball of the hip joint. The bone can weaken and lose its rounded shape, making the joint surface irregular. Early disease may be assessed for treatments that preserve the femoral head, but replacement becomes more relevant when collapse, arthritis, or structural damage has developed.

The surgeon considers pain at rest or with activity, walking tolerance, sleep disruption, hip movement, imaging findings, age, bone quality, medical conditions, and the condition of the socket. The aim is to replace damaged joint surfaces and improve function, while recovery still requires staged strengthening and movement practice.

Arrange an orthopaedic assessment if hip pain, limping, stiffness, or difficulty with shoes, stairs, or sitting is progressing. Imaging helps show whether the femoral head has collapsed and whether the socket is affected. Keep activity within a tolerable range, use an advised walking aid, and review medicines that may influence bone health with the clinician who prescribed them.

Read more about [Total Hip Replacement](/treatments/joint-replacement/total-hip-replacement/).

Seek urgent assessment for sudden severe hip pain after a fall, inability to bear weight, a shortened or visibly rotated leg, fever with a hot swollen joint, or new weakness or numbness. These symptoms can indicate a fracture, infection, or nerve problem requiring prompt evaluation.

Ask whether the femoral head has collapsed, what the scans show about the socket, whether a joint-preserving option remains suitable, how other health conditions affect planning, and what milestones guide walking and rehabilitation after replacement.