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Osteonecrosis or Avascular Necrosis (AVN)

From about age 6 I had always been playing football (soccer). It dominated my life for the next 15 years or so and I was quite happy to allow that. My time on the field started to wane when I began traveling the nation for my ex employer IBM. Six days a week on the road is not conducive to exercise or organized sports and as a result I gained quite a few kilos. I think I weighted over 90 kilos at one point. (multiply by 2.2 for your inferior “standard” weights system) I decided this was not acceptable and decided to join my friends in triathlons to get back into shape. It was at this time (two years ago now) that I found out that I had to give up football for the rest of my years as those trixsy doctors diagnosed me with osteonecrosis which translates to BONE DEATH!

Osteonecrosis is when your bones have a restricted flow of blood and they are unable to regenerate themselves. All the time your bones are dying and rebuilding, but alas, mine are not. For me it is located at the top of the femoral head inside the hip joint. A good summary can be found at There are much more sites talking about this subject but none really go past the information explained here.

When I ran, I could only last about 20 minutes before I had some serious pain start in my hips. I thought it might be a hip flexor problem but it felt more internal. I went to the doctor and told him the problem. I had X-rays, then MRIs, then more MRIs, and initially I was told that I had torn a ligament inside my hip joint called the ligamenteres ligament. This ligament is used while you are an embryo to supply blood to the legs but is not used once you are fully developed but still remains. They decided on arthroscopic surgery to remove this ligament and all should be solved. I was in and out in a day and I thought my life would be back to normal. I went to physical therapy every day for about 6 weeks at an amazing place called Orange County Impact Rehabilitation which is run by a marvelous person by the name of Willis. During this time I would get stronger and stronger but be sure not to do any real exercise outside the clinic. This was hard for someone like me to do and I started to run again after a few weeks. After which my leg would be extremely sore and I would have to go to Willis and tell him what I had done and he would shake his head in disapproval and we would start again. 8 weeks went by and no real improvements and I went back to the doctor. More MRIs and it was now apparent that it was not the ligament but indeed it was osteonecrosis. On the MRI you could see a dark quadrant in my femoral head showing dead bone. I was crushed as this was exactly what I did not want to happen. I had done my reading and knew there was no cure and the ultimate solution was a hip replacement.

My doctor was one of the best in Orange County and his words to me every time I went to see him was to just go for as long as you can and when I could not bare the pain anymore, they would look to surgical solutions. They will not give me a new hip since I am too young and would likely need two or three replacements in my life due to current hip replacement technology. Other options are to have holes drilled in my femur to promote blood flow or even take shin bone and inject it into the hip bone. All of which have below 40% success rates. So what the fuck?

Now I can just get an X-ray and the problem can be seen. I prefer MRIs really since I do not enjoy laying under an X-ray machine that is several inches away from my man tools and zapping away. It does make for a funny moment when I am with the doctor looking at the X-rays and he is pointing out the affected area and there is a very clear image of my penis he is trying to ignore. Did you know that one air plane flight is the equivalent of 15 X-rays? So I was told…

As for how it was caused, they do not know. Steroids? not likely. Alcoholism? I drink but no where near enough or for long enough to be considered an alcoholic. Blunt impact? Possible but who knows when that would have happened. I started to notice hip pain at university during my 8 hours a day of playing football with the collegiate team. Maybe it was too much for little old me.

But not to be held down, I have adjusted. Evident in some of my past blogs, I have picked up cycling in an extreme way. I ride at least 100 miles a week and try to race regularly. Thank you to Willis for encouraging this past time. I find that if I do not cycle, my hip will start to hurt again so I long for many hours on my saddle when I have been away from it for even several days. I also swim quite a lot as well which causes no pain. Basically I cannot do anything that gives my legs a lot of impact. Yoga can be very nice as well and I stretch everyday. Even walking can be a bugger sometimes. I have always been a fast walker and love to be that guy knocking over people as I squeeze through crowds but I have toned down my pace to avoid enduring pain.

My weight is back to a modest 75 kilos and I feel great. I do not look forward to the days ahead when I will be a cripple in a wheel chair trying to play tennis or volleyball but I will deal with that when it comes. For now, I just wait for medicine to advance. Maybe I will end up being one of these guys riding a hand powered bicycle…

I purchased a document online about a grafting procedure. At the time of my diagnosis I was hoping this was the end all solution. But the document was a waste of money for me. It is from the University of Duke by doctors that anyone reading this article has probably heard about since Duke is supposed to be on the cutting edge of this procedure. The dates are old and the results and their percentages are dismally low. Too low for my liking. There is one comment below from a lady who did this and sounds like she is still waiting for it to kick in so do not expect immediate results. Anyways, to help this developing community out, here is the document that I purchased for all to read and understand. If anyone has any other documents that might be helpful please feel free to email me them at [email protected] and I will post them here.

Duke AVN Bone Grafting

Helpful Links

A few readers and commenters have been very kind and eager to help this growing community and support group. Here are some links and docs that I have received.

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