AVN (avascular necrosis) is the death of bone in the femoral head due to loss of blood supply, often linked to steroids, alcohol or trauma. Early stages are treated with core decompression; late stages need hip replacement.
Causes of AVN
Long-term steroid use, alcohol excess, trauma, sickle cell disease, and post-COVID inflammation are the leading causes in India.
Staging
Ficat stages I–II (no femoral head collapse) can be treated with core decompression and bone grafting to save the joint.
Stages III–IV (collapsed head) need hip replacement — and in young patients, hip resurfacing may be an option.
Surgery in young patients
Modern ceramic-on-ceramic or ceramic-on-polyethylene bearings are perfect for patients in their 30s and 40s.
Robotic hip replacement gives perfect leg length and the best long-term implant survival.