Treatment helps to keep bone in joints from breaking down.
Without treatment, most people with the disease will have severe pain and
limited movement within 2 years.
The goals in treating osteonecrosis are:
- To improve use of the joint
- To stop further damage
- To protect bones and joints.
For early stage disease, doctors may first order nonsurgical
treatments. If they do not help, surgery may be needed.
Nonsurgical treatments may relieve pain in the short term, but
they do not cure the disease. One or more of these treatments may be used at
the same time.
Medications. Nonsteroidal anti-inflammatory drugs (NSAIDs) are used to
reduce pain and swelling. For people with blood clotting problems, blood
thinners may be used to prevent clots that block the blood supply to the
bone. If you take steroid medications, cholesterol-lowering drugs may be
used to reduce fat in the blood.
Taking weight off the joint. Your doctor may suggest that you limit
your activity or use crutches to take weight off the affected joint. This
may slow bone damage and allow some healing. If combined with NSAIDs, it
may help you avoid or delay surgery.
Range-of-motion exercises. Exercise of the joints with osteonecrosis
may help increase their range of motion.
Electrical stimulation. Research has shown that this can prompt bone
In time, most people with osteonecrosis need surgery. There
are four main types of surgery used for osteonecrosis. Your doctor will decide
if you need surgery and what type is best for you.
Core decompression surgery. Lowers pressure inside the bone to increase
blood flow to the bone.
Osteotomy. Reshapes the bone to reduce stress on the damaged joint.
Bone graft. Takes healthy bone from one part of the body and uses it to
replace diseased bone.
Total joint replacement. Replaces the joint with a man-made one.
National Institute of
Arthritis and Musculoskeletal and Skin Diseases, USA.