Avascular necrosis of the hip and how it differs from other hip conditions
Nicola Tik
If you have been diagnosed with avascular necrosis of the hip, you may have found that it feels and behaves differently from other hip conditions you have come across. This article explains what is happening and what makes it distinct.
Avascular necrosis, sometimes referred to as AVN or osteonecrosis, occurs when the blood supply to the head of the femur, the ball at the top of the thigh bone that forms the hip joint, is disrupted. Without adequate blood supply, the bone tissue in that area gradually weakens and can eventually collapse if the condition is not managed.
It differs from osteoarthritis, which involves the gradual wearing of joint cartilage, and from inflammatory conditions like RA, which are driven by the immune system. AVN is specifically about bone health and blood supply rather than cartilage or inflammation, which is why its pattern and management have their own particular logic.
Pain in the groin is the most characteristic feature of AVN, though it can also be felt in the outer hip, buttock, or thigh. It tends to be felt most during weight bearing, particularly walking, standing, and moving from sitting to standing, and may ease when you are off your feet.
In the earlier stages, some people have significant imaging findings with relatively mild symptoms. In later stages, as the bone weakens further, pain tends to become more consistent and weight bearing more difficult. Where you are in that progression shapes how you manage activity.
Because AVN involves structural bone changes rather than soft tissue or cartilage, the priority with load management is somewhat different. The goal is to reduce the mechanical stress going through the affected femoral head while keeping the surrounding muscles and the rest of the body as active as possible.
This means that low or non-weight bearing activity, such as swimming or cycling, is generally more appropriate than high impact or sustained weight bearing during periods when the hip is more reactive. Walking remains useful but distance and terrain matter more than they might with other hip conditions.
Keeping the muscles around the hip, particularly the gluteal muscles at the back and side of the hip, gently active supports the joint and reduces the load it has to manage directly. Seated and lying exercises that work these muscles without heavy weight bearing load are a practical starting point.
Avoiding prolonged standing on hard surfaces and managing stairs carefully, one step at a time if needed, reduces cumulative load through the affected hip during more reactive periods.
Your specialist or GP is central to managing AVN, particularly regarding weight bearing guidance and monitoring progression. VIDA supports the movement and self-management side alongside that care.