What it is

Avascular necrosis of the femoral head is loss of blood supply to the ball of the hip in adolescents or adults. The affected bone weakens and may collapse, leading to arthritis if not treated in time.

Early disease can be silent or present with deep groin pain. Prompt recognition improves options.

What happens when it occurs

The femoral head loses its blood supply and the bone architecture fails under normal load. If collapse occurs, joint congruence is lost and arthritis follows.

Common causes and risk factors

  • Previous hip fracture or dislocation
  • Corticosteroid exposure and heavy alcohol intake
  • Sickle cell disease and other systemic conditions

Who is most affected

Adolescents and adults with the above risk factors and people with unexplained deep hip pain.

Typical symptoms

  • Deep groin pain with walking and rotation
  • Night pain in advanced stages
  • Stiffness and reduced walking distance

When to seek care

Seek medical assessment when deep hip pain persists or risk factors are present. Early MRI can detect disease before collapse.

How we diagnose

Clinical assessment and range testing. X-rays define later stages. MRI diagnoses early disease and guides staging.

Management

  • Activity modification and protected weight bearing in early stages
  • Medications and bone support strategies as advised by the medical team
  • Core decompression or osteotomy in selected cases
  • Total hip replacement for collapsed or arthritic joints

Rehabilitation milestones

Phase 1: pain control and protected weight bearing, gait with aids.

Phase 2: progressive strength and balance while respecting load limits.

Phase 3: return to daily function and low-impact fitness.

Post-surgery: criteria-based protocols coordinated with the surgeon.

Readiness to progress

  • Stable pain at rest and with walking
  • Improved strength and range within planned limits
  • Imaging and surgical guidance for load changes

Prevention

  • Avoid unnecessary corticosteroid exposure and moderate alcohol intake
  • Address hip injuries promptly and follow weight-bearing advice
  • Manage systemic conditions with your medical team

Australia snapshot

  • Less common than osteoarthritis in clinics
  • Often referred through hospital orthopaedic services
  • Early MRI access improves planning in metropolitan centres

Latest insights

Detect early and protect the femoral head from collapse to preserve the joint.

Surgical options depend on stage and patient goals.

Frequently Asked Questions

They share loss of blood supply but affect different age groups. AVN refers to adolescents and adults, Perthes to younger children.

Early stages can improve with protected loading and medical care. Later stages with collapse often need surgery.

Yes when AVN is suspected. MRI detects early disease before X-rays change.

Crutches are used for weeks while the bone strengthens. Strength and walking tolerance are rebuilt stepwise.

When the head has collapsed or arthritis limits function despite other care.

Plan tasks around weight-bearing limits early. Return is staged with your team.

Favour low-impact exercise while healing. Return to impact depends on imaging and symptoms.