Osteonecrosis is a condition where bone tissue dies due to an interruption of blood supply. It can affect any bone but most commonly affects the hip joint. Symptoms include joint pain and tenderness. Doctors diagnose through x-rays, MRI, CT scans, and bone scans. Treatment depends on the stage of disease and may include medications to improve blood flow, hyperbaric oxygen therapy, electrical stimulation, core decompression surgery, bone grafts, or in severe cases, joint replacement surgery.

1. OSTEONECROSIS
Carolina Marioni

3. WHAT IS
OSTEONECROSIS?

4. SYMPTOMS

5. DIAGNOSIS
WHAT DOES A DOCTOR CHECK FOR?
• Sensitive areas near joints
• Tenderness of the specific area
• Stiffness of joints
• If the doctor has a reason to think the patient may have
osteonecrosis, he/she can run more test to be sure like:
• X-rays
• Magnetic Resonance Imaging (MRI)
• Computerized Tomography (CT scan)
• Bone scan

6. BONE SCAN
A small amount of radiopharmaceutical is injected into the
arm.
The bone scan determines problems with the bone
metabolism(the process the body undergoes to break down
and rebuild the bone)
The small amounts of radiopharmaceutical then runs
through the veins throughout the entire body.
The damaged areas will then “light up” because the
radiopharmaceutical will naturally go to the damaged area.
If the patient has no disease or damage to the body the
radiopharmaceutical will not build up in a certain area,
rather evenly flow through the entire body (following the
vein flow).

7. CAUSES
The overall cause of osteonecrosis is the shortage of
the supply of red blood cells to the bone, but what
causes that?
There are two types of osteonecrosis:
• traumatic osteonecrosis
• non-traumatic osteonecrosis
The types depend on how the patient got
osteonecrosis.

8. TRAUMATIC OSTEONECROSIS
When the bone gets
damaged, so does
everything around
and in it. This means
that the blood flow
gets reduced and
doesn’t get to the
bones the way it once
did.

9. NON-TRAUMATIC OSTEONECROSIS

10. NON-TRAUMATIC OSTEONECROSIS
CONTINUED…
Gaucher disease Decompression disease Sickle cell disease

11. PREVENTION
Even though preventive measures can be taken osteonecrosis can happen to anyone, so it is
best for people to always be aware of their body and the warning signs it gives.

12. WHO GETS OSTEONECROSIS?
About ten thousand to
twenty thousand people
every year in the United
States between the ages of
30-50.
• Can still occur in people
younger or older.

13. TREATMENT
• Even though there is no known cure for osteonecrosis there are still many
treatments as an option for people with this disease
• Because it is difficult to diagnose this condition early on most people aren't
diagnosed until months or years after they have it
• Due to this, there are no early treatments to completely salvage the bone loss
• To determine the best treatment the doctor must consider:
• age of the patient
• stage of the disease
• location of the damage
• amount of the bone that's affected
• Doctors will do what they can to salvage the bone and the joint and to stop
further damage of it. There are non-operative treatments and surgical
treatments.

14. NON-OPERATIVE TREATMENTS

15. HYPERBARIC OXYGEN THERAPY
• Being in a room with the air pressure three
more times higher than normal while breathing
pure oxygen.
• This technique can help with better blood flow
through the veins and causes a stimulant to
release growth factors and stem cells which
help with a faster healing process

16. ELECTRICAL STIMULATION
Electrodes are places on skin where electric
impulses are sent.
This can help with the limited movement of
the joints that osteonecrosis causes.

17. MEDICATION
Anticoagulants
are blood
thinners used to
prevent blood
clots in veins, so
blood can move
through them
with ease.
Bisphosphonates are specifically
made for osteonecrosis. It stops the
osteoclast from breaking down the
bone allowing the osteoblast to
continue building up the solid
ground substance of the bone.
Vasodilators are
used to make the
blood vessels wider,
allowing more
blood to flow
through the vessels
Lipid lowering agents
decrease the amount of
lipid in the blood; this
means that there are
less lipids (fatty
substances) in
bloodstream.

18. PHYSICAL THERAPY

19. SURGICAL TREATMENTS

20. CORE DECOMPRESSION AND BONE GRAFTS

21. OSTEOTOMY
Osteotomy is another surgical procedure used to decrease the amount of pressure the
bone is undergoing. In this procedure, Surgeons will go in and literally reshape the bone
in a manner or it'll feel less pressure

22. ARTHROPLASTY
Arthroplasty is a total joint replacement. This surgery is used when the osteonecrosis is so
advanced the joint has been totally damaged. The joint replacement is completely
substituted with artificial parts

23. WHICH BONES/ JOINTS ARE AFFECTED THE MOST?
Osteonecrosi
s can affect
any bone in
the body, but
the hip joint
is the most
common.

24. MOLECULAR LEVEL
• Through the process of ossification bone
is build up, using osteoblast
• While it is building up, the bone is also
undergoing the breaking down of bones
using osteoclast cells.
• Osteoblast cells are made from
osteogenic cells (stem cells)
• A large supply of blood is needed for the
cells to transfer from osteogenic to
osteoblast
• If there isn’t enough blood: osteogenic
cells will transfer into chondroblast

25. STAGES OF OSTEONECROSIS

26. BEFORE AND AFTER PICTURES

27. HIP JOINT

28. SHOULDER JOINT

29. TEETH

30. ANKLE

31. HAND

32. OSTEONECROSIS