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Condition · 2 treatment paths

Avascular Necrosis of Hip

Avascular necrosis of the hip is death of bone in the head of the thigh bone, caused by loss of its blood supply. It can lead to collapse of the joint surface.

Severe
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Treatment paths
2Treatment paths
Specialties
1Specialties
Typical severity
SevereTypical severity

About avascular necrosis of hip

What to know

The main symptom is groin or thigh pain, first on activity and later at rest, with a limp and stiffness. Causes include steroid use, heavy alcohol use, previous hip injury and some blood disorders, and sometimes none is found. X-rays may look normal early on, so MRI is used for diagnosis, and staging guides treatment.

Early disease may be treated with protected weight-bearing and pain relief, and with core decompression, sometimes with bone grafting, to preserve the joint. Once the head has collapsed, hip replacement is the usual treatment, and metal-on-metal hip resurfacing is occasionally chosen for young, active people with good bone. Treatment of the underlying cause is also important. Recovery after replacement takes about three months.

Pre-flight workup

Tests to have already done

  • Hip X-rays (pelvis and frog-lateral views) and MRI showing the stage of necrosis and size of the affected area.
  • Staging of the disease, such as the ARCO or Ficat classification, and whether the femoral head has collapsed.
  • Evidence of the other hip, since necrosis is often bilateral, with MRI of both sides.
  • History of risk factors: steroid use, heavy alcohol intake, sickle cell disease, trauma or clotting disorders.
  • Records of core decompression, grafting or other previous hip surgery.

Second opinion

When to get a second look

  • Hip replacement is advised for early disease before collapse, when joint-preserving surgery may still be considered.
  • You are young and want to compare resurfacing with total hip replacement.
  • The other hip has not been imaged although necrosis is often bilateral.
  • Pain is severe and you have a known cause such as steroids or sickle cell disease that must be managed too.

Talking to your doctor

Questions to ask

  1. What stage is my necrosis, and has the femoral head collapsed?
  2. Is a joint-preserving operation worth trying in my case?
  3. Is the other hip affected?
  4. What are the pros and cons of resurfacing versus total hip replacement for someone my age?
  5. How long might a replacement last, and could I need another?
  6. How can I reduce the risk factors that caused this?

Outlook

Realistic prognosis

Without treatment, many hips with necrosis progress to collapse and arthritis, particularly with larger lesions. Joint-preserving surgery can delay or avoid replacement in early disease. Hip replacement relieves pain and restores function in most people, though replacements in younger patients may need revision in later decades. Stage, lesion size, cause and age shape the outcome.

01 · Specialties

Specialties that treat Avascular

Specialists Doctors who treat avascular necrosis of hip Cross-hospital roster across 1+ relevant specialties. View roster

Diagnostic workup

Before you pick a hospital, get the workup right

Severe — workup typically within 48–72 hours

Picking the right treatment is downstream of a complete diagnosis. Skip steps here and the destination surgeon usually re-orders them anyway — at higher cost and another week on the ground.

  1. Confirm the diagnosis on imaging or labs

    For avascular necrosis of hip, plan on the workup your home doctor would order anyway — typically a recent specialist consult plus the imaging / labs the destination team will need to quote accurately. Anything older than 90 days usually gets re-done.
  2. See a orthopedics specialist locally first

    An in-person clinical exam at home — even a single consult — costs little and dramatically improves the destination plan. Bring back: written impression, recommended procedure, surgical-risk class, and any contra-indications.
  3. Send us the file for a free second opinion

    Two surgeons in our medical panel review the workup independently. They tell you whether they'd operate, watch, or refer — even if that means recommending against travel.
  4. Pick a path with timeline + cost in writing

    Once a treatment is the right call, we line up 2–3 hospital options with itemized quotes, surgeon profiles, and a travel timeline. You hold the file — switch hospitals or step away at any point.

03 · Treatment paths

Treatment options

All treatments

Where to be treated

Avascular Necrosis of Hip treatment by destination

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04 · FAQ

Common questions about avascular necrosis of hip

Will I definitely need a hip replacement?

Not always. Early disease may be treated with joint-preserving procedures, but many hips collapse over time and need replacement.

Could the other hip be affected?

Yes. Necrosis often affects both hips, so MRI of the other side is usually advised even without pain.

Can I keep walking on it?

Often with support and protected weight-bearing. Your surgeon will advise based on stage and pain.

Clinical context

Working up avascular necrosis of hip properly

A condition like avascular necrosis of hip is rarely well-served by jumping straight to treatment shopping. The sequence below is what a orthopedics specialist would expect to see completed — and the absence of any step is the right cue to delay travel decisions.

Diagnostic workup, in sequence

  1. First-line clinical assessment

    History, physical exam, and risk-factor review by a senior generalist or orthopedics specialist. Symptoms list, family history, prior workup notes, and current medication list should travel with the patient.

  2. Standard imaging + labs

    Baseline blood work, condition-specific imaging (ultrasound / X-ray / MRI / CT — depending on indication), and ECG / pulmonary function as relevant. Bring digital copies of any prior imaging — saves repeat scans and the cost that goes with them.

  3. Specialist diagnostic workup

    Procedure-specific tests — biopsy, cardiac catheterisation, endoscopy, or genetic / molecular profiling depending on the suspected diagnosis. Done at the centre that will treat, ideally, so results integrate cleanly into the treatment plan.

  4. Multidisciplinary review (where indicated)

    Cancer, complex cardiac, transplant, and rare-disease cases should be reviewed by a multidisciplinary panel — surgical, medical, imaging, and pathology — before any treatment commits. Single-discipline plans for complex disease are a quality red flag.

When to escalate urgently

  • Acute worsening of established symptoms — sudden chest pain, shortness of breath at rest, neurological deficit, severe bleeding, persistent high fever.
  • Loss of consciousness, severe persistent vomiting, or any focal neurological event.
  • Symptoms in the early hours of onset that fit a time-sensitive treatment window (stroke, MI, sepsis) — every hour costs outcome.
  • If you are travelling internationally for treatment and develop these symptoms in transit, divert to the nearest emergency department; do not wait to reach the planned destination.

Before you book international travel

  • Confirm your specific diagnosis is fully worked up before you commit to a treatment plan abroad. Travelling for the workup is fine; travelling for treatment without the workup done is not.
  • Get your case reviewed remotely by the destination centre's team before you book flights — credible international patient programs review imaging + reports before they confirm the surgical plan.
  • Bring a digital + physical copy of your full medical record: imaging on USB drive in DICOM format, labs in PDF, current medication list with dosages, allergies, and any prior surgical reports.
  • Plan for the post-op rehabilitation phase before you fly — the surgery itself is rarely the bottleneck.
  • Confirm that follow-up imaging and any necessary in-person reviews can be done at home — a treatment plan that requires repeat international trips is more burdensome (and more expensive) than the headline procedure.
How this page is made

Methodology and editorial standards

This avascular necrosis of hip overview is written by the editorial team from published Orthopedics sources and lists 2 treatment options offered by hospitals on our network. The page shows its last-updated date. Clinical descriptions are editorial — your treating clinician confirms what's right for your specific case.

  1. Hospital data. Hospital details are compiled from public sources and hospital websites. Accreditation (JCI, NABH and others) is shown where we hold a record of it. Always ask the hospital for its current certificate.
  2. Doctor credentials. Qualifications, specialty and bio come from the doctor's hospital profile. Licence is checked against the national medical-council register only where the profile shows a "Licence verified" badge with a date.
  3. Prices. Price ranges are indicative, compiled from hospital price lists and packages and shown with the date last updated. The hospital's written quote is what you pay against.
  4. Clinical text. Written by the Medcasts editorial team from published clinical sources. Unless a named reviewer is shown on the page, it has not been reviewed by a doctor.
  5. Independence. Hospitals cannot pay to change their position on our pages.
Data sources for this page
Peer-reviewed clinical guidelines (NCCN, ESMO, ESC, AHA, NICE — by indication)WHO ICD-11 condition classificationNational medical society treatment protocolsJCI accreditation registry

Avascular Necrosis of Hip

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