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Health condition

Avascular necrosis of the hip

Avascular necrosis (AVN) of the hip is death of bone in the femoral head from interrupted blood supply, typically causing groin pain in adults aged 30-60; caught before the head collapses, joint-preserving treatment is possible - which makes early MRI decisive.

Why trust this guide

  • 01

    Editorial team

    Written by our editorial team from the UK sources listed on each page.

  • 02

    Sourced from guidance

    Checked against current NHS and UK specialist society guidance at the time of review.

  • 03

    Current for 2026

    Reviewed on 2026-09-27 with the next review scheduled for 2027-09-27.

Key facts

The essentials at a glance.

The symptoms to recognise, when to seek help, which specialist to see, and what treatment usually involves.

  • Groin pain worsening with weight-bearing in a younger adult, often with normal early X-rays - MRI detects AVN months before X-ray changes

  • Major risk factors: corticosteroid therapy, high alcohol intake, previous hip fracture or dislocation, sickle cell disease, chemotherapy and deep-sea diving

  • Staging (pre-collapse vs post-collapse) drives everything: core decompression and biologic adjuncts can save a pre-collapse head

  • Once the femoral head collapses, total hip replacement - which performs excellently even in younger patients - is usually the answer

Understanding the condition

What it is and what happens next.

What causes it, how it is diagnosed, and the treatment routes available in the UK.

What it is and how it feels

The femoral head lives on a precarious blood supply, and when steroids, alcohol, trauma or clotting tendencies choke it, a wedge of bone dies quietly: pain often precedes X-ray change by months while the dead segment weakens under load until the joint surface caves. Both hips are involved in a substantial minority, so the other side is routinely imaged.

Diagnosis and treatment routes

A hip specialist stages the disease with MRI and plans by stage and lesion size: pre-collapse disease may be offered core decompression (drilling to relieve pressure and stimulate repair), sometimes with bone graft or biologic augmentation, alongside managing the underlying cause; established collapse is treated definitively with hip replacement. Bisphosphonates and reduced weight-bearing have limited, selected roles - the strategic point is simple: unexplained persistent groin pain in an at-risk adult warrants MRI, not serial X-rays. In much of the UK, a routine NHS referral to the relevant specialist clinic can take several months, whereas an initial appointment with a private consultant is typically available within around two weeks.

Seeing a specialist

Who to see, and how quickly you can be seen.

The specialist for this condition is usually a consultant orthopaedic (hip) surgeon. Your GP can refer you on the NHS, or you can arrange a private consultation directly.

A quiet reminder

This guide is for information, not medical advice.

Your GP knows your history and can tell you which parts apply to you. If in doubt, see them - and seek urgent care for any of the emergency symptoms described above.

Frequently asked

Common questions about Avascular necrosis of the hip.

Quick, plain-English answers to what people ask us most.

  • What is avascular necrosis of the hip?

    Avascular necrosis of the hip is a recognised medical condition that can affect people in different ways, ranging from mild and easily managed to more significant, depending on the underlying cause, how early it is picked up, and how it is treated. Getting a clear diagnosis is usually the first step towards the right management plan.

  • What causes avascular necrosis of the hip?

    Avascular necrosis of the hip can arise from a combination of factors, which may include genetics, lifestyle, environmental exposures, other underlying health conditions, or simply the normal effects of ageing on the body. In many cases no single cause is found, and several factors act together. A clinician can help identify which factors are most relevant in an individual case.

  • What are the symptoms of avascular necrosis of the hip?

    Symptoms of avascular necrosis of the hip vary from person to person and depend on how severe the condition is and which structures are affected. Some people notice symptoms gradually over weeks or months, while others experience a more sudden onset. Because symptoms can overlap with other conditions, a proper assessment is important to reach an accurate diagnosis rather than relying on symptoms alone.

  • Is avascular necrosis of the hip serious or dangerous?

    Most cases of avascular necrosis of the hip are manageable, especially when identified and treated early, but severity varies from mild and self-limiting to more significant, depending on individual circumstances. Left unassessed, some cases can lead to complications or a longer-term impact on daily life. If you are worried about your symptoms, it is always worth getting them checked rather than waiting.

  • Is avascular necrosis of the hip hereditary or genetic?

    Some cases of avascular necrosis of the hip have a genetic component and can run in families, while others occur without any family history at all. Having a relative with the condition may modestly increase your own risk, but it does not mean you will definitely develop it yourself. If you are concerned about a family history, mention this to your doctor, as it may occasionally influence screening or monitoring.

  • Can avascular necrosis of the hip be cured, reversed or prevented?

    Outlook varies with avascular necrosis of the hip: some cases resolve completely with treatment, others improve significantly but need ongoing management, and a smaller number become a long-term condition to be controlled rather than cured. Prevention strategies, such as addressing modifiable risk factors, can reduce your chances of developing it or of it recurring, but cannot guarantee against it in every case.

  • How is avascular necrosis of the hip treated?

    Treatment for avascular necrosis of the hip is tailored to the individual and depends on severity, underlying cause and personal circumstances. Options can range from simple lifestyle measures, monitoring and conservative treatment through to medication, specialist procedures or surgery in more significant cases. A specialist assessment helps identify which combination of treatments is most appropriate for you.

  • How long does avascular necrosis of the hip last?

    The duration of avascular necrosis of the hip varies considerably: some people recover within days or weeks, while others live with a more persistent or recurring condition that needs ongoing management. Response to treatment, how early it is started, and individual factors all influence the timescale. Your clinician can give you a more personalised estimate once your specific circumstances are known.

  • When is surgery needed for avascular necrosis of the hip?

    Surgery is not usually the first option for avascular necrosis of the hip and is generally reserved for cases where conservative treatment has not worked, symptoms are severe, or there is a significant structural problem that needs to be corrected directly. The decision depends on your specific findings, symptoms and how they are affecting your life. A specialist consultation is the best way to establish whether surgery is being considered too early, or should be considered sooner rather than later.

  • When should I see a doctor about avascular necrosis of the hip, and how quickly can I be seen privately?

    It is worth seeing a doctor about avascular necrosis of the hip if symptoms are persistent, getting worse, or affecting your daily life, rather than waiting to see if they settle on their own. NHS routine referrals to a specialist can currently take anywhere from around 20 to 45 weeks or more depending on your area, whereas a private consultant can typically see you within about 2 weeks. Getting an earlier assessment can help clarify the diagnosis and start the right treatment sooner.