Hip health · JOINT HEALTH JOURNAL
Hip Osteonecrosis in Younger Adults: Preserve or Replace?
Osteonecrosis, also called avascular necrosis or AVN, occurs when bone loses an adequate blood supply. It can affect younger adults too. The choice of treatment depends on the extent of damage, whether the femoral head has collapsed and its effect on daily life—not age or walking ability alone.
Symptoms can be less obvious than expected
Early disease may have few symptoms. Later, discomfort can occur in the groin or buttock and become more noticeable with weight bearing. Injury, some medicines and medical conditions may be relevant, although a cause is not always clear. Share any corticosteroid history; do not stop prescribed treatment on your own.
Why blood supply matters
Imaging helps define the stage and extent
X-rays show bone shape and joint changes. If early osteonecrosis is suspected despite an unrevealing X-ray, MRI may provide more information. The assessment looks at location, size and collapse as well as diagnosis, helping clarify whether preserving the natural hip remains an option.
Imaging provides complementary information
Preservation or replacement depends on the findings
Selected patients before collapse may be considered for core decompression, sometimes with bone grafting. Preservation cannot guarantee that the disease will stop progressing. When collapse and joint damage significantly affect life, total hip replacement may be discussed. Both pathways require follow-up and individual activity advice.
Stage the disease, then discuss options
Ask: “Has the femoral head collapsed? Am I a candidate for preservation? How would we monitor it?” Discussing imaging alongside your life goals is more useful than age alone.
Medical references
General education does not replace an individual assessment. Treatment is tailored to your condition and goals. Diagrams explain concepts, not an individual diagnosis.