Illustration showing Avascular Necrosis (AVN) inside the bone

What is Avascular Necrosis ( AVN ) ?

Avascular Necrosis (AVN), also known as Avascular Necrosis, is a serious bone condition in which the blood supply to the bone gradually reduces, causing the bone tissue to weaken and die over time.
 
This problem is increasingly being seen in patients from Indore and nearby regions of Madhya Pradesh, especially among young and middle-aged adults. AVN most commonly affects weight-bearing joints like the hip, knee, and shoulder, leading to persistent pain, stiffness, and difficulty in walking if not diagnosed early. With growing awareness and access to advanced orthopedic care in Indore and nearby MP cities, early identification of avascular necrosis AVN can help save the natural joint and avoid major surgery.

 

This article is written to explain only one thing clearly: What exactly is AVN and what happens inside the bone when AVN develops.

 

Avascular Necrosis (AVN) in One Simple Line

AVN (Avascular Necrosis) is a condition in which a part of the bone slowly dies because it does not receive enough blood.

Bones are living tissue.
They need a constant blood supply just like the heart or brain .
When that blood flow reduces or stops, the bone becomes weak from inside

What Actually Happens Inside the Bone in Avascular Necrosis (AVN)?

To understand Avascular Necrosis AVN, imagine this Blood carries oxygen and nutrients to bone cells

In AVN, this blood flow gets interrupted
• Bone cells start dying
• Dead bone becomes fragile With body weight and movement, the bone starts collapsing
• This collapse is permanent damage.

Why AVN (Avascular Necrosis ) Is a “Silent” Disease

One dangerous thing about AVN is that:
Bone damage starts before pain starts

In early stages:

• Bone death has already begun
Joint surface still looks normal
• Patient may feel little or no pain

That’s why many patients from Ratlam, Khandwa, and nearby areas get diagnosed late.

Progression of AVN (Disease Timeline)

AVN does not remain the same. It progresses if untreated.
(Disease Timeline)

Stage 1: Early Avascular Necrosis (AVN)

1.  Bone damage microscopic
2.  X-ray normal
3.  Blood supply reduced
4.  MRI shows AVN

       Stage 2: Progressive Avascular Necrosis (AVN)

1   Bone weakens
2. Shape still maintained

           Stage 3: Bone Collapse in Avascular Necrosis (AVN)

1 Bone surface collapses
2 Joint starts losing smoothness

               Stage 4: Advanced Joint Damage in Avascular Necrosis (AVN)

1   Severe joint damage
2  Arthritis develops
3  Pain becomes constant
4  Once collapse happens, the joint cannot return to normal.

Stages of Avascular Necrosis AVN of the hip joint showing early reduced blood supply, progressive bone damage, femoral head collapse, and advanced joint destruction

 Why Hip Joint Is Most Commonly Affected

The hip joint (femoral head) has:

• Limited blood supply
• High body weight load
• Less margin for damage

That’s why AVN of the hip is most common, especially in active adults aged 30–50.
Patients from Indore and Bhopal often think it’s just “muscle pain” initially.

AVN (Avascular Necrosis ) Is NOT Just “Joint Pain”

This is important to understand

• AVN is not a muscle problem
• Not simple arthritis in early stages
• Not age-related wear and tear
• It is bone death from inside, which is why ignoring pain can be dangerous.

 Why Early Diagnosis Changes Everything

If AVN is detected before bone collapse

• Joint-saving options are possible
• Disease progression can be slowed
• Natural joint may be preserved
• Once collapse occurs:
• Damage becomes irreversible
Joint replacement may be the only solution

This is why MRI-based early diagnosis is crucial

Causes of Avascular Necrosis (AVN)

Avascular Necrosis  (AVN)   develops when the blood supply to the bone is reduced or interrupted. Common causes include:

  1. Long-term or high-dose steroid medication use
  2. Excessive alcohol consumption
  3. Hip or joint injury, fracture, or dislocation
  4. Certain medical conditions affecting blood flow
  5. In some cases, no clear cause is identified

Symptoms of Avascular Necrosis (AVN)

Symptoms of Avascular Necrosis (AVN)  are often mild in the early stages and gradually worsen over time:

  1. Hip or groin pain during walking or weight bearing
  2. Joint stiffness and reduced range of motion
  3. Pain that increases after activity or prolonged standing
  4. In advanced stages, constant pain and difficulty walking

Avascular Necrosis ( AVN )Awareness in Madhya Pradesh

In my practice in Indore, I see many patients from:

Most of them say:
 “Doctor, hume AVN ke baare me pehle kisi ne bataya hi nahi.”

                                                    “Awareness is the first step to prevention of damage.”

Hindi Summary (संक्षेप में)

AVN (एवैस्कुलर नेक्रोसिस) एक बीमारी है जिसमें हड्डी को जाने वाला खून कम हो जाता है, जिससे हड्डी अंदर से धीरे-धीरे खराब होने लगती है।
• यह बीमारी शुरू में बिना दर्द के भी हो सकती है
हिप जॉइंट सबसे ज़्यादा प्रभावित होता है
• समय पर पहचान होने से जॉइंट बचाया जा सकता है देर होने पर हड्डी बैठ जाती है

Swahili Summary (Kwa Ufahamu Rahisi)

AVN (Avascular Necrosis) ni hali ambapo mfupa haupati damu ya kutosha na huanza kufa taratibu

  • Huathiri zaidi joint ya nyonga
  • Uharibifu huanza kabla ya maumivu
  • Utambuzi wa mapema unaweza kuokoa joint
  • Ucheleweshaji husababisha uharibifu wa kudumu

Frequently Asked Questions – Understanding AVN

1. एवीएन का मतलब क्या होता है?

हड्डी को रक्त की आपूर्ति ना मिलनी और हड्डी का डैमेज होना।

नहीं, बिना इलाज के यह बीमारी धीरे-धीरे आगे बढ़ती जाती है।

हाँ, शुरुआती स्टेज में दर्द नहीं भी हो सकता है।

शुरुआती स्टेज में X-ray से AVN दिखाई नहीं देता।

AVN की शुरुआत हड्डी से होती है, जबकि arthritis की शुरुआत जॉइंट से होती है।

इसका मतलब है कि हिप की हड्डी का आकार बिगड़ जाना या बैठ जाना।

देर से किया गया diagnosis (लेट डायग्नोसिस)।

AVN दोनों hips में हो सकता है।

इंदौर में AVN (Avascular Necrosis) के इलाज के लिए Dr. Anupam Khandelwal को एक अनुभवी और भरोसेमंद ऑर्थोपेडिक विशेषज्ञ माना जाता है। वे Indore में AVN के early diagnosis, non-surgical management और advanced surgical options (जैसे core decompression, joint-preservation procedures और hip replacement) में विशेषज्ञता रखते हैं।

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