Aseptic Necrosis of the Hip

International Elite Care provides expert care for aseptic necrosis hip with top-level medical expertise.

Avascular necrosis of the hip occurs when the head of the femur no longer receives an adequate blood supply. The bone gradually weakens, may become deformed and can cause pain, stiffness or reduced mobility. It is one of the main hip diseases, requiring specialist assessment to limit its progression and functional consequences.

Hip bone necrosis most commonly affects adults, including younger and active patients, and may develop silently at first. Without appropriate management, it can lead to progressive joint destruction and eventually require surgery.

Diagnostic process for an avascular necrosis hip

To diagnose avascular necrosis hip, a consultation with an orthopaedic surgeon specialising in the hip is recommended. The surgeon will assess the nature and intensity of the pain, its location (groin, hip or thigh), as well as any potential risk factors.

Imaging tests, including X-rays and MRI scans, are essential to confirm the diagnosis and determine the stage of aseptic necrosis of a hip (hip necrosis without infection).

Based on all clinical and radiological findings, the surgeon determines:

• the stage of the necrosis,
• the extent of damage to the femoral head,
• the most appropriate medical or surgical treatment options.

At International Elite Care, every patient receives a personalised assessment. This is essential for selecting the most appropriate treatment approach based on their age, lifestyle and expectations.

Hip avascular necrosis: symptoms and clinical manifestations

Hip avascular necrosis symptoms may take time to become noticeable because the condition develops progressively and is often silent in its early stages. Symptoms generally appear when the bone begins to weaken, with severity varying according to the stage of the disease.

What are the most common symptoms of avascular necrosis of the hip? Let take a closer look.

Hip pain

In cases of hip necrosis, pain is the most common symptom. It often occurs:

• in the groin,
• on the side of the hip,
• sometimes radiating towards the thigh or knee.

Pain associated with bone necrosis in hip may occur during physical activity or prolonged walking, then become more persistent, including at rest or at night.

Joint stiffness

Patients may experience a gradual reduction in hip flexibility, with discomfort during certain movements such as standing up, sitting down, climbing stairs or bending over.

As the condition progresses, pain and reduced mobility may lead to:

• difficulty walking long distances,
• intermittent or persistent limping,
• increased fatigue when moving around,
• limitations in sports activities.

Necrosis in the hip can therefore have a significant impact on everyday comfort and quality of life.

Origins and causes of necrosis of the hip

Understanding the causes of necrosis of the hip requires consideration of several different factors.

Hip trauma

Trauma such as a hip fracture or dislocation can damage the blood vessels supplying the femoral head. This vascular damage may occur immediately or develop over time, sometimes several months after the accident.

Prolonged medication use

Long-term or high-dose corticosteroid use is one of the causes most frequently associated with hip necrosis. These treatments can alter the blood supply to the bone and contribute to the development of the condition.

Excessive alcohol consumption

Heavy and prolonged alcohol consumption can impair the microcirculation of the bone, increasing the risk of femoral head necrosis.

Associated diseases and disorders

Among hip necrosis causes, certain conditions may contribute to its development, including:

• certain inflammatory or autoimmune diseases,
• blood-clotting disorders,
• metabolic or vascular diseases.

In some cases, no specific cause can be identified. This is known as diopathic hip necrosis.

Hip necrosis: surgery and treatments by expert surgeons

Treating hip necrosis surgically is possible, but surgery is not always necessary. When the condition is managed at an early stage, a conservative approach may be considered. Several hip necrosis treatment options are available, with the aim of preserving the joint and replacing it only when deterioration makes this necessary.

Non-surgical treatments (early stages)

If necrosis of the hip is diagnosed at an early stage, before the femoral head becomes deformed, conservative management is preferred. This may involve:

• adapting activities to reduce stress on the hip,
• using pain-relieving treatment to manage symptoms,
• temporarily reducing the load placed on the joint, for example with a walking stick or crutches.

Once these measures have been implemented, regular medical monitoring is essential. This makes it possible to assess the effectiveness of treatment and determine whether the condition is progressing. Depending on the progression of hip necrosis, a more advanced treatment may be considered.

Hip-preserving surgery

For some patients, particularly younger and active individuals, joint-preserving surgery may be considered to delay or potentially avoid hip replacement.

One such procedure is core decompression of the femoral head. Small channels are created in the bone to reduce pressure inside the femoral head. This can relieve pain and promote improved blood flow to the affected area.

In some cases, the surgeon may supplement this procedure with techniques designed to stimulate bone reconstruction, using a bone graft or biocompatible materials. The aim is to encourage natural bone repair and slow the progression of the necrosis.

These procedures are possible as long as the shape of the joint remains preserved and the femoral head has not undergone irreversible deformation.

Prosthetic surgery (advanced stages)

When hip necrosis stages progress to the point where the femoral head becomes deformed and the joint is damaged, total hip replacement becomes necessary.

This involves replacing the damaged joint with modern implants designed to restore mobility, provide lasting pain relief and enable a rapid return to everyday activities.

Thanks to advanced surgical techniques and the expertise of International Elite Care’s specialist surgeons, this procedure offers reliable and long-lasting results, with a high level of comfort for the patient.

Our answers to your questions about avascular necrosis in hips

Find out more about avascular necrosis in hips and the solutions available through International Elite Care.