Avascular Necrosis of the Femoral Head (AVN)
Table of Contents
What is avascular necrosis of the femoral head
Avascular necrosis (AVN) of the femoral head is a condition in which blood flow to the femoral head is interrupted, causing the bone tissue to die (necrose). If the blood-flow disruption persists, the bone in the necrotic area weakens, the femoral head collapses, and eventually full-blown osteoarthritis of the hip develops. AVN occurs most often in men in their 30s to 50s, and early detection has a major impact on prognosis.
Major risk factors
- Excessive alcohol use: The most common cause of AVN in Korea — alcohol disrupts fat metabolism and obstructs the microvessels inside the femoral head.
- Long-term steroid use: The risk rises sharply with high-dose steroid therapy for autoimmune diseases and similar conditions.
- Trauma: Vascular damage after a femoral neck fracture or hip dislocation can lead to AVN.
- Idiopathic: Some cases occur without an identifiable cause.
The importance of early MRI diagnosis
In the early stages of AVN, X-rays often appear normal. If groin pain persists and risk factors are present, MRI is essential. MRI accurately identifies the extent of necrosis within the femoral head, allowing clinicians to determine the disease stage and treatment plan.
Korean medicine adjunctive treatment: invigorating blood and removing stasis (活血祛瘀)
In Korean medicine, AVN is understood as a qi-blood circulation disorder of the bone marrow caused by blood stasis (瘀血). The core therapeutic principle is to invigorate blood and remove stasis (activate blood flow and clear stagnation).
- Herbal medicine: Combining blood-activating herbs such as peach kernel (Persicae Semen), safflower (Carthami Flos), and Angelica gigas with kidney-tonifying, bone-strengthening herbs to restore blood flow to the femoral head and promote bone regeneration.
- Acupuncture: Stimulation of points around the hip improves local blood flow.
- Moxibustion: Warming stimulation enhances deep circulation.
Co-management with conventional medicine is essential
AVN is a condition in which Korean medicine alone has clear limits. When the area of necrosis is large or the femoral head has begun to collapse, total hip replacement (THR) may be required. Korean medicine treatment serves to slow progression in early-stage disease, support the patient before and after surgery, and manage pain — and must always be carried out in collaboration with an orthopedic surgeon.