What is the role of drug treatment for femoral head avascular necrosis (AVN)?

Updated: Oct 22, 2018
  • Author: John D Kelly, IV, MD; Chief Editor: Craig C Young, MD  more...
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Medical therapy for AVN of the hip is principally indicated for relief of discomfort. Nonsteroidal anti-inflammatory drugs (NSAIDs) and, on occasion, narcotics, form the basis of pharmacotherapy. Investigations into vasoactive lipid-lowering agents and anticoagulants are ongoing and hold promise [7, 22, 23] (eg, studies suggest low molecular weight heparin [LMWH] may prevent the progression of idiopathic osteonecrosis of the hip [21] ); however, these medications are not currently recommended. Inhibition of the vascular endothelial growth factor may hold promise in preventing femoral head collapse because revascularization compromises bone structural integrity. Because medical comorbidities are common in patients with AVN, the use of selective cyclooxygenase (COX)–2 inhibitors is appealing.

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