How is Osteonecrosis Treated?

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. To decide on the best treatment, your doctor will find out:

• Your age
• The stage of the disease
• Where and how much bone has osteonecrosis
• The cause, if known. If the cause is steroid or alcohol use, treatment may not work unless you stop using those substances

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.

Surgery

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.