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Risk factors
By Mayo Clinic staffThe two most common risk factors of avascular necrosis are:
- Corticosteroids. People who take high doses of corticosteroids, such as prednisone, for long periods of time — for instance, people with chronic illnesses such as rheumatoid arthritis and lupus — are more likely to experience avascular necrosis.
- Heavy drinking. Several alcoholic drinks a day for several years can cause fatty deposits to form in your blood vessels. This can restrict the flow of blood to your bones. The more alcoholic drinks you consume on a daily basis, the higher your risk of avascular necrosis.
Osteoporosis drugs may harm jaw
People who take bisphosphonates — a type of medicine used to help strengthen bones weakened by osteoporosis — sometimes develop osteonecrosis of the jaw. This risk is higher for people who have received high doses of bisphosphonates intravenously to counteract the damage caused by cancer in the bones.
Procedures can increase risk
Several types of medical procedures can weaken bones, making it easier for you to develop avascular necrosis. Examples include:
- Cancer treatments such as chemotherapy or radiation
- Dialysis, a process to clean the blood after kidney failure
- Kidney and other organ transplants
Conditions linked to bone death
Many underlying medical conditions increase your risk of developing avascular necrosis. They include:
- Diabetes
- Gaucher's disease
- HIV
- Kienbock's disease
- Legg-Calve-Perthes disease
- Lupus
- Sickle cell anemia
- What is osteonecrosis? National Institute of Arthritis and Musculoskeletal and Skin Diseases. http://www.niams.nih.gov/Health_Info/Osteonecrosis/osteonecrosis_ff.asp. Accessed Oct. 26, 2009.
- Donohue JP. Osteonecrosis (avascular necrosis of bone). http://www.uptodate.com/home/index.html. Accessed Oct. 26, 2009.
- McKown K. Osteonecrosis. American College of Rheumatology. http://www.rheumatology.org/public/factsheets/diseases_and_conditions/osteonecrosis.asp?aud=pat. Accessed Oct. 26, 2009.
- Osteonecrosis of the hip. American Academy of Orthopaedic Surgeons. http://orthoinfo.aaos.org/topic.cfmtopic=A00216. Accessed Oct. 26, 2009.
- Chang C, et al. Osteonecrosis. In: Firestein GS, et al. Kelley's Textbook of Rheumatology. Philadelphia, Pa.: W.B. Saunders Co.; 2008. http://www.mdconsult.com/das/book/body/167338938-3/908256960/1807/704.html#4-u1.0-B978-1-4160-3285-4..10094-4_3424. Accessed Oct. 27, 2009.
- Goytia RN, et al. Bisphosphonates and osteonecrosis: Potential treatment or serious complication? Orthopedic Clinics of North America. 2009;40:223.
- Dabov G. Osteonecrosis. In: Canale ST, et al. Campbell's Operative Orthopaedics. 11th ed. Philadelphia, Pa.: Mosby Elsevier; 2007. http://www.mdconsult.com/das/book/body/167687025-3/909040867/1584/174.html#4-u1.0-B978-0-323-03329-9..50028-3--cesec56_987. Accessed Oct. 28, 2009.
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