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Osteonecrosis Treatment

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

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 growth.


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.