Avascular Necrosis

Avascular Necrosis (Osteonecrosis): Non-Surgical Options in Palm Beach

Avascular necrosis (AVN), also called osteonecrosis, occurs when the blood supply to a section of bone is disrupted, causing the bone tissue to die. The hip is the most commonly affected joint, though AVN can also involve the knee, shoulder, and other joints.

When caught in early stages, orthobiologic treatment combined with core decompression may help support the bone's healing environment and slow disease progression. Advanced AVN typically requires surgical joint replacement. To find out if this procedure is right for you, contact us today.

What Is Avascular Necrosis (Osteonecrosis)?

Without adequate blood supply, bone cells (osteocytes) die, weakening the structural integrity of the bone. Over time, the bone surface can collapse, leading to joint destruction and severe arthritis.

Early-stage AVN (before collapse) is the window in which non-surgical treatment approaches have the most potential to make a difference.

Signs and Symptoms

• Hip, groin, or thigh pain, often beginning gradually
• Pain that worsens with weight-bearing
• Stiffness and limited range of motion
• Groin pain at rest in advanced stages
• Limp or altered gait

Common Causes and Risk Factors

• Long-term or high-dose corticosteroid use (most common non-traumatic cause)
• Excessive alcohol consumption
• Prior hip fracture or dislocation disrupting blood supply
• Sickle cell disease or other blood disorders
• Decompression sickness (in divers)
• Radiation therapy

How It Is Diagnosed

MRI is the most sensitive tool for detecting early AVN, before changes are visible on X-ray. Staging (Ficat & Arlet or ARCO classification) guides treatment decisions and prognosis.

Dr. Ghattas will review your imaging to determine the stage of AVN and whether non-surgical options are appropriate.

Conventional Treatment Options

• Core decompression surgery: Drilling into the affected bone to reduce pressure and promote vascular ingrowth, most effective in early stages
• Protected weight-bearing: To prevent joint collapse during early disease
• Medications: Blood thinners and bisphosphonates, studied with variable results
• Total joint replacement: For advanced AVN with joint collapse

The Palm Beach Regenerative Approach

For appropriately staged early-to-mid-stage AVN, Dr. Ghattas may discuss the potential role of orthobiologic treatment, including bone marrow concentrate (BMC), to support the bone's biological environment and healing response.

This approach may be considered in conjunction with core decompression or as part of a broader treatment plan. The goal is to support the body's ability to maintain bone integrity before structural collapse occurs.

Advanced AVN with joint collapse typically requires surgical joint replacement. Dr. Ghattas will provide an honest assessment of whether the stage and location of your AVN make you an appropriate candidate for non-surgical intervention.

The BioMod Advantage: At Palm Beach Regenerative, treatment does not end with a single injection. Through our BioMod Lab, Dr. Ghattas may combine your orthobiologic procedure with MLS Robotic Laser Therapy to reduce inflammation and support tissue recovery, alongside customized Xymogen supplement protocols designed to optimize your body's healing environment. This integrated, concierge approach is what sets Palm Beach Regenerative apart from a standard injection clinic.

Like all medical procedures, orthobiologic treatments have potential risks and benefits. Results vary by individual. Not all patients are candidates. Dr. Ghattas will discuss your specific situation, realistic expectations, and all treatment options, including when surgery or other interventions may be more appropriate.

Orthobiologic treatment for AVN is most relevant in early-to-mid stages before joint collapse. Advanced-stage AVN with significant bone death or joint destruction typically requires surgical joint replacement. Dr. Ghattas will provide an honest assessment based on your imaging.