Osteonecrosis, an insidious disease that often requires surgery

Although we may sometimes think that bones are something inert and immutable, the truth is that they are living tissue that, like the rest of our body, is susceptible to disease.

What is this and why is it happening?

As noted by the National Library of Medicine of the United States, osteonecrosis is a condition that occurs when part of a bone lack of sufficient blood flow and dies. Without treatment, this leads to deterioration of the joint to which the bone belongs and therefore to severe arthritis.

Often it is result of a serious illness or injury which affects the blood supply to the bone, although it sometimes occurs idiopathically (for no apparent reason).

Some of possible triggers include intravenous or oral steroids, alcohol abuse, sickle cell disease, displacement of fractures around the joint, bleeding disorders, HIV or anti-HIV drugs, radiation therapy, chemotherapy, HIV Gaucher disease (which causes the accumulation of harmful substances in some organs and bones), systemic lupus erythematosus (autoimmune disease), Legg-Calvé-Perthes disease and decompression sickness in deep-sea divers.

What are the symptoms?

Osteonecrosis can be quite insidious, as it is common in the early stages it proceeds without symptoms. But then signs like:

  • Joint pain that begins gradually until it eventually becomes very strong and manifests itself even at rest.
  • Limited range of motion.
  • Worsening of arthritis symptoms.

You may need to have a physical examination with this photo. X-rayMRI, bone scan or CT scan to correctly diagnose the disease.


How is it treated?

For the most part, treatment should focus on treats the underlying condition and in slowing the progression of the disease, restricting joint movement and using painkillers. However, surgery is usually required.

In particular, the options are bone injectionvascularized bone graft (along with its blood supply), removal of part of the inside of the bone (which stimulates the formation of new blood vessels), osteotomy (change in bone orientation) or even complete change of joints.


Osteonecrosis. MedlinePlus, available at https://medlineplus.gov/spanish/ency/article/007260.htm on 17.06.2022.

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