Risk factors for developing avascular necrosis include:
- Trauma. Injuries, such as hip dislocation or fracture, can damage nearby blood vessels and reduce blood flow to bones.
- Steroid use. High-dose use of corticosteroids, such as prednisone, is the most common cause of avascular necrosis that isn't related to trauma. The exact reason is unknown, but one hypothesis is that corticosteroids can increase lipid levels in your blood, reducing blood flow and leading to avascular necrosis.
- Excessive alcohol use. Consuming several alcoholic drinks a day for several years also can cause fatty deposits to form in your blood vessels.
- Bisphosphonate use. Long-term use of medications to increase bone density may be a risk factor for developing osteonecrosis of the jaw. This complication has occurred in some people treated with these medications for cancers, such as multiple myeloma and metastatic breast cancer. The risk appears to be lower for women treated with bisphosphonates for osteoporosis.
- Certain medical treatments. Radiation therapy for cancer can weaken bone. Organ transplantation, especially kidney transplant, also is associated with avascular necrosis.
Medical conditions associated with avascular necrosis include:
March 21, 2015
- Gaucher's disease
- Systemic lupus erythematosus
- Sickle cell anemia
- Ferri FF. Ferri's Clinical Advisor 2015: 5 Books in 1. Philadelphia, Pa.: Mosby Elsevier; 2015. https://www.clinicalkey.com. Accessed Jan. 23, 2015.
- Jones LC, et al. Osteonecrosis (avascular necrosis of bone). http://www.uptodate.com/home. Accessed Jan. 19, 2015.
- Firestein GS, et al. Kelley's Textbook of Rheumatology. 9th ed. Philadelphia, Pa.: Saunders Elsevier; 2013. http://www.clinicalkey.com. Accessed Jan. 23, 2015.
- AskMayoExpert. Who gets avascular necrosis of the hip? Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2015.
- Questions and answers about osteonecrosis (avascular necrosis). National Institute of Arthritis and Musculoskeletal and Skin Diseases. http://www.niams.nih.gov/Health_Info/Osteonecrosis/default.asp. Accessed Jan. 23, 2015.
- Chang-Miller A (expert opinion). Mayo Clinic, Phoenix/Scottsdale, Ariz. Jan. 29, 2015.
- Issa K, et al. Osteonecrosis of the femoral head: The total hip replacement solution. Bone & Joint Journal. 2013;95-B:46.
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