AVN ( Avascular Necrosis of Hip)


Avascular necrosis of Hip is a condition that results in death of bone tissue in the head of the thigh bone, as a result of impaired local blood circulation to the bone. Hip is the most common joint affected by the condition with lack of blood supply resulting in tiny breaks in the bone and the hip joint collapse leading to Secondary Osteoarthritis of the Hip Joint. Severe hip pain could result due to Secondary Osteoarthritis which occurs if Avascular Necrosis of Hip is untreated. Common causes for Avascular Necrosis of hip include trauma/ hip dislocation, the long term use of high-dose steroid medications and excess alcohol intake. The condition remains unnoticed as they exhibit very few or no symptoms until the damage deepen on the affected joint. The patient may experience pain in the groin, thigh or buttock.

The condition is diagnosed by performing an X-ray, MRI scan or CT scan to obtain detailed images that showcase early changes in hip bone. Conventional treatment methods are aimed to prevent further bone loss from the hip area. Specific treatment options depend on the amount of bone damage in the patient. Depending on the condition, the doctor recommends Nonsteroidal anti-inflammatory drugs, Osteoporosis drugs, Rest and losing excess weight to reduce stress on the affected bone can slow the phase of damage. Surgical procedure is the most important line of treatment which includes core decompression, bone transplant or reshaping and joint resurfacing/ replacement.

Alternative treatment methods at Beth Yehuwdah Arthritis Centre, Pullad and Daystar Clinic, Alappuzha

Alternate treatment method called Platelet Rich Plasma Prolotherapy is available for those with Secondary Osteoarthritis due to neglected Avascular Necrosis of Hip who do not wish / not medically fit to undergo surgery.

Platelet Rich Plasma for Secondary Osteoarthritis due to Avascular Necrosis of Hip :
Plasma rich platelet prolotherapy is the recent trend in treating various joint conditions and is designed to stimulate repair of chronically inflamed synovium, torn ligaments in the affected joint and to reduce swelling and pain caused by the condition. PRP prolotherapy is a combination treatment where PRP is injected into the joint and dextrose prolotherapy is given to the ligaments of the joint. This treatment may help a patient who does not want surgery and it helps to overcome the disease condition with minimally invasive injection techniques. The treatment method stimulates the natural immune repair mechanisms of the body and assists in the repair of damaged tissues.

How does PRP work? Blood components are of four major types - plasma, platelets, white blood cells and red blood cells. Platelets assist in clotting and are also the “first-responders” of the body post injury; helping repair an injured region and in building up of new tissue and thereby promoting the healing process. Once platelets contact collagen in damaged tissues, the platelets release various biological growth factors (Table 1 as given below) to promote healing in soft tissues locally. Activated platelets commonly release the following growth factors:

Platelet-Derived Growth Factor (PDGF)

Attracts cells of the immune system to the site and stimulates their proliferation. Also shown to assist in healing of ligaments and tendons.

Transforming Growth Factor-ß (TGF-ß)

Similar affects as PDGF. It is Secreted by all major cell types involved in healing.

Vascular Endothelial Growth Factor (VEGF)

Helps in formation of new blood vessel, thereby increasing vascularity in injured areas.

Fibroblast Growth Factor (FGF)

Promotes the growth of the cells involved in collagen and cartilage formation.

Table 1: Various biological growth factors released by PRP when activated

PRP injection delivers a high concentration of autologous (patient’s own) platelets to the hip, where secondary osteoarthritis is present. Platelets present in the blood are the first responders to an injured area and helps build up new soft tissues. Introducing high concentration of platelets directly into the joint using PRP injection stimulates the healing process and faster recovery from the joint condition.
Patient Benefits of PRP Prolotherapy

  • Minimally invasive treatment method
  • Almost painless injection technique using very thin needles under local anesthesia
  • For those who wish to avoid if not delay/ those unfit for Joint Replacement/ Resurfacing Surgery
  • Significantly reduces the symptoms associated with Secondary Osteoarthritis
  • Reduced risk of adverse events
  • Assists in repair and tightening of ligaments improving joint stability and ease of walking
  • Safe and effective treatment method
  • Assists healing and recovery
  • PRP Prolotherapy usually results in safe, significant, improvement of hip pain, function and reduction of stiffness in most patients.

    At Beth Yehuwdah Arthritis Centre, Pullad & Daystar Clinic, Alappuzha we tailor a customized treatment plan to treat patients suffering from Avascular Necrosis of Hip. To know more about treatments and treatment cost, contact us/ book an appointment now –

Ask Doctor

Our Doctor


Dr. Tejaz Koshy John

Consultant for Orthobiologics, Regenerative & Interventional Orthopaedics

MBBS, MS Ortho (Christian Medical College, Ludhiana), Joint Replacement Fellowship (HOSMAT Hospital, Bangalore), Orthopaedic Trauma Fellowship (Hebrew University Hospital, Jerusalem, Israel)

Read More


Book Appointment