What is the prognosis of avascular necrosis (AVN)?

Updated: Dec 05, 2020
  • Author: Sunny B Patel, MD; Chief Editor: Herbert S Diamond, MD  more...
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Answer

The prognosis of AVN depends on the disease stage at the time of diagnosis and the presence of any underlying conditions. More than 50% of patients with AVN require surgical treatment within 3 years of diagnosis. Half of patients with subchondral collapse of the femoral head develop AVN in the contralateral hip. [46]

Poor prognostic factors include the following:

  • Age older than 50 years
  • Advanced disease (stage 3 or worse) at the time of diagnosis
  • Necrosis of more than one third of the weight-bearing area of the femoral head on MRI
  • Lateral involvement of femoral head (compared with medial lesions)
  • Non-modifiable risk factors such as cumulative dose of corticosteroids (corticosteroid-induced AVN)

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