Which histologic findings are characteristic of avascular necrosis (AVN)?

Updated: Dec 05, 2020
  • Author: Sunny B Patel, MD; Chief Editor: Herbert S Diamond, MD  more...
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Histology is the criterion standard for diagnosis of AVN, although it is usually unnecessary. The histologic specimen is usually obtained during surgery, although it is occasionally obtained during diagnostic bone biopsy. Histologic changes are observed in both cortical bone and bone marrow.

In the early stage, interstitial edema and plasmostasis is confined to the bone marrow. As the severity progresses, osteocytes continue to disappear and necrotic tissue fills the medullary spaces. New living bone is laminated onto dead trabeculae with partial resorption of dead bone. In the subchondral trabeculae, bone resorption exceeds formation leading to the net removal of bone, loss of structural integrity of trabeculae, subchondral fracture, and joint incongruity [6] .

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