Avascular Necrosis and Disability | Osteonecrosis

Osteonecrosis occurs when poor blood supply to an area causes bone death. This lack of blood can cause bone tissue to die and may also result in the collapse of the bone. Although the disease is most commonly associated with people in their 30s, 40s and 50s, it can develop at any age, young or old. Also, though it can affect women, aseptic necrosis is more often found in men. Most individuals experience the condition in the hips and shoulders. However, it also affects other large joints such as the knees elbows, wrists and ankles.

Some other names for osteonecrosis are:

  • Avascular necrosis;
  • Osteonecrosis;
  • Ischemic bone necrosis;
  • AVN; and
  • Aseptic necrosis

When part of the bone does not get blood, it dies. After a while, the bone may even collapse. If the condition remains untreated, the joint will ultimately deteriorate and cause severe arthritis.

Cause of Osteonecrosis

Osteonecrosis is caused by any condition that affects the blood supply to the bone, including disease or a severe trauma, such as a break or dislocation. Bone trauma or fracturing causes blood vessels to break, which cuts off the blood supply to the bone. However, there does not need to be a traumatic injury to cause the condition. In fact, oftentimes no trauma or disease is present. If the cause is unknown, this is called “idiopathic osteonecrosis”, meaning it occurs without any known cause.

Without blood, small cracks can appear in the bone, eventually leading to a collapse. It can also damage the surface of a nearby joint.

The following can also cause osteonecrosis:

  • Long-term treatments with steroids
  • Excessive alcohol use
  • Sickle cell disease
  • Radiation therapy
  • Gaucher disease
  • Decompression sickness from a lot of deep sea diving
  • Dislocation or fractures around a joint

Related Conditions

Some other disorders or diseases that may be associated with the development of osteonecrosis include:

  • Gout;
  • Atherosclerosis; and
  • Diabetes

When osteonecrosis occurs in the shoulder joint, it is most often caused by either: (1) long-term treatment with steroids or (2) a history of trauma to the shoulder.

Symptoms

Joint pain is the first sign of aseptic necrosis commonly experienced. It may only appear when putting pressure on the affected joint, but can also persist when the joint is resting. How much pain you experience may depend on how much damage has been caused to the bone and surrounding joints and whether or not a collapse has occurred.

As bone damage accelerates, you may experience the following symptoms:

  • Pain in the joint that increases over time, and will become extremely severe if the bone totally collapses;
  • Pain that occurs even when not in motion;
  • Limited range of motion;
  • Groin pain, if the hip joint is affected
  • Limping, if the condition occurs in or below the hips

Diagnosis Via Exams and Tests

Your medical provider should conduct a physical exam to determine whether you have any diseases or conditions that may affect your bones. Be sure to advise your doctor about any medications or vitamin supplements you are taking, even over-the-counter medicine.

After a physical examination, your medical provider may order one or more of the following tests:

  • X-ray
  • MRI
  • Bone scan
  • CT scan

Treatment

If your medical provider identifies the reason for the osteonecrosis, your treatment may be targeted to the underlying condition. For example, if a blood clotting disorder is the reason, your treatment may consist of clot-dissolving medicine.

If the condition is caught the early stages, you may take pain relievers and limit use of the affected area. Nonsurgical treatment can often slow the progression of the condition, but most people may ultimately require surgery.

Surgical options include:

  • A bone graft
  • A bone graft along with its blood supply (vascularized bone graft)
  • Cutting the bone and changing its alignment to relieve stress on the bone or joint (osteotomy)
  • Total joint replacement or
  • Removing part of the inside of the bone (core decompression) to relieve pressure and allow new blood vessels to form

Possible Complications

Advanced osteonecrosis can lead to osteoarthritis and permanent decreased mobility. Severe cases may even require total joint replacement.

Avascular Necrosis and Disability

A person can become disabled due to aseptic necrosis, depending on which bones are affected and how quickly and effectively the bone can rebuild. Even though the human body is in a constant state of bone restructure, during this disease the bone tissue is torn with such consistency that the usual healing process is ineffective. This is what causes bone collapse and pain.

If you suffer from avascular necrosis, you may be eligible for Long Term Disability or Social Security disability benefits. Contact Mr. Ortiz at 850-308-7833 to discuss your rights today.