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Osteonecrosis is a problem caused by a short-term or
permanent loss of blood supply to the bone. When blood doesn’t get to bones
they begin to break down, weaken, and eventually collapse. Osteonecrosis is
also called avascular necrosis or “AVN,” “aseptic necrosis, or ischemic bone
Am I at Risk?
Survivors who received bone marrow, cord blood, or stem cell
transplants, as well as those who received corticosteroids (such as prednisone
and dexamethasone) during cancer treatment are at risk for osteonecrosis.
Risk is even higher if you also had:
Osteonecrosis is most likely to occur during cancer treatment.
But it sometimes happens after treatment ends. It can be disabling, depending
on what part of the bone is affected, how large an area is involved, and how
well the bone rebuilds itself. If it progresses, it can lead to pain and
It can occur in any bone, but most often affects the ends of
long bones, such as the thigh bone, causing hip and knee problems. If it occurs
near a joint, the joint can collapse. Other common sites are the bones of the
upper arms, shoulders, and ankles. It can occur in one bone, but most often
occurs in a few at one time.
People with osteonecrosis may not have any symptoms at
first. But as the disorder progresses, most will have some joint pain. The pain
may start when you put weight on the bone or joint, but in time it may hurt
even at rest. It may become severe enough to limit movement in the affected
joint. How long between the first symptoms and loss of joint function varies by
person and ranges from months to years.
A number of tests can be done to diagnose osteonecrosis.
The goals of treatment for osteonecrosis are to improve use
of the affected joint, reduce pain, stop bone damage, and ensure the joint
lives. Factors that will affect your treatment include your age, whether the
condition is in the early or late stage, the location and amount of bone affected,
and the status of your cancer treatment.
One or more conservative treatments may be used. They include:
Because conservative treatments may not provide lasting improvement,
some people need surgery to repair or replace the joint, such as these.
In addition to conservative and surgical treatment, you can
help manage osteonecrosis by following these tips:
You can find more information on osteonecrosis from these