Avascular Necrosis (Osteonecrosis): Non-Surgical Options in Palm Beach
Avascular necrosis (AVN), also called osteonecrosis, occurs when the blood supply to a section of bone is disrupted, causing the bone tissue to die. The hip is the most commonly affected joint, though AVN can also involve the knee, shoulder, and other joints.
When caught in early stages, orthobiologic treatment combined with core decompression may help support the bone’s healing environment and slow disease progression. Advanced AVN typically requires surgical joint replacement. To find out if this procedure is right for you, contact us today.
What Is Avascular Necrosis (Osteonecrosis)?
Without adequate blood supply, bone cells (osteocytes) die, weakening the structural integrity of the bone. Over time, the bone surface can collapse, leading to joint destruction and severe arthritis.
Early-stage AVN (before collapse) is the window in which non-surgical treatment approaches have the most potential to make a difference.
Signs and Symptoms
- Hip, groin, or thigh pain, often beginning gradually
- Pain that worsens with weight-bearing
- Stiffness and limited range of motion
- Groin pain at rest in advanced stages
- Limp or altered gait
Common Causes and Risk Factors
- Long-term or high-dose corticosteroid use (most common non-traumatic cause)
- Excessive alcohol consumption
- Prior hip fracture or dislocation disrupting blood supply
- Sickle cell disease or other blood disorders
- Decompression sickness (in divers)
- Radiation therapy
How It Is Diagnosed
MRI is the most sensitive tool for detecting early AVN, before changes are visible on X-ray. Staging (Ficat & Arlet or ARCO classification) guides treatment decisions and prognosis.
Dr. Ghattas will review your imaging to determine the stage of AVN and whether non-surgical options are appropriate.
Conventional Treatment Options
- Core decompression surgery: Drilling into the affected bone to reduce pressure and promote vascular ingrowth, most effective in early stages
- Protected weight-bearing: To prevent joint collapse during early disease
- Medications: Blood thinners and bisphosphonates, studied with variable results
- Total joint replacement: For advanced AVN with joint collapse
The Palm Beach Regenerative Approach
For appropriately staged early-to-mid-stage AVN, Dr. Ghattas may discuss the potential role of orthobiologic treatment, including bone marrow concentrate (BMC), to support the bone’s biological environment and healing response.
This approach may be considered in conjunction with core decompression or as part of a broader treatment plan. The goal is to support the body’s ability to maintain bone integrity before structural collapse occurs.
Advanced AVN with joint collapse typically requires surgical joint replacement. Dr. Ghattas will provide an honest assessment of whether the stage and location of your AVN make you an appropriate candidate for non-surgical intervention.
The BioMod Advantage: At Palm Beach Regenerative, treatment does not end with a single injection. Through our BioMod Lab, Dr. Ghattas may combine your orthobiologic procedure with MLS Robotic Laser Therapy to reduce inflammation and support tissue recovery, alongside customized Xymogen supplement protocols designed to optimize your body’s healing environment. This integrated, concierge approach is what sets Palm Beach Regenerative apart from a standard injection clinic.
Like all medical procedures, interventional orthobiologics have potential risks and benefits. Results vary by individual. Not all patients are candidates. Dr. Ghattas will discuss your specific situation, realistic expectations, and all treatment options, including when surgery or other interventions may be more appropriate.
Orthobiologic treatment for AVN is most relevant in early-to-mid stages before joint collapse. Advanced-stage AVN with significant bone death or joint destruction typically requires surgical joint replacement. Dr. Ghattas will provide an honest assessment based on your imaging.
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"Honestly one of the best experiences, I’ve had a really stiff neck for a couple weeks I tried seeing a chiropractor for and it helped marginally but the real jump in relief was coming to see Dr. Ghattas! He has been incredible, wonderful staff, and minimally invasive technique for my pain relief which was super important to me! Thank you Dr. Ghattas recommending to anyone with pain!"Monica A
"Ghattas was instrumental in helping my torn rotator cuff. I did Barbotage for the stone, and then PRP. Great experience. Been about a month or 2 since and I feel great."Ahmet B
"I had severe knee pain and was looking for proper knee pain treatment, which is how I found Dr. Ghattas on Instagram. I was a bit hesitant at first, but it turned out to be one of the best decisions I’ve made for my health. Francia was amazing at coordinating all my consultations and making the whole process easy and stress-free. If you’re dealing with knee pain and looking for a reliable doctor and team, I highly recommend them."Roger L
"Over a year ago, both my daughter and I underwent PRP treatment with Dr. Ghattas—PRP for my left knee and PRP for my daughter’s L4-L5 and sacral region. We wanted to wait long enough to truly evaluate the results before sharing our experience. I am pleased to say that the outcomes have been outstanding. My daughter’s improvement has been remarkable, and the treatment has made a significant difference in her quality of life. I have also experienced excellent results with my knee. Dr. Ghattas is an exceptional physician who combines expertise, professionalism, and genuine care for his patients. We are incredibly grateful for the treatment we received and the positive impact it has had on our lives. Thank you, Dr. Ghattas. We are truly grateful for everything you have done. You are simply the best."Dr Jorge A
"Dr. Ghattas is very knowledgable and a sympathetic doctor. Hard to find in America. All questions answered, my procedure went very smoothly, very little pain. Follow up is excellent, I highly recommend his practice."Luciana D
“ I had severe knee pain and was looking for proper knee pain treatment, which is how I found Dr. Ghattas on Instagram. I was a bit hesitant at first, but it turned out to be one of the best decisions I’ve made for my health. Francia was amazing at coordinating all my consultations and making the whole process easy and stress-free. If you’re dealing with knee pain and looking for a reliable doctor and team, I highly recommend them. ”Roger L
“Dr. Ghattas was terrific today. He spent a good amount of time examining me and explaining the regenerative process which I intend to have done next month. More to come after the procedure.”Louie R
“I found Dr Ghattas and his staff very welcoming and informative. The process was well explained and gave me encouragement about the potential for fully restoring my knee joint integrity.”Eric C
“I received two treatments from Dr. Ghattas With excellent results, he takes great care in his assessment and in his treatment you couldn’t be in better hands. I highly recommend his work.”Gisela S
“Apart from the exemplary personal service by the reception and the staff that makes us feel we're at home at the clinic, I have experienced remarkable healing in several episodes from shoulder issue to knee injuries and hip pain. The doctor is so thorough in the diagnosis phase that he administered exactly what was needed, no more no less! Thank you folks for a wonderful experience.”RG G
“Went to Dr. Ghattas for chronic knee and neck issue. I’ve already had multiple procedures done on my neck and multiple epidurals with minimal success. My knee I was told needed surgery to fix. I already had surgery in the past with minimal difference. I ended up getting stem cells in my knee and neck and could t be happier with the outcome. Anyone considering surgery I recommend checking out Regenex first. Next I’m doing the ganglion block and look forward to the results.”Logan H
“Dr. James Ghattas and his team are truly top-notch. His office is equipped with state-of-the-art technology and a staff that's exceptional in their fields. I've referred several clients to him, and they've all been incredibly satisfied. Dr. Ghattas is absolutely ahead of the curve, and I wholeheartedly endorse his work.”Ron H
“I am quite active and go to pilates 3-4 times per week. I was having left knee pain and which was treated with PRP. It took about 3 months for me to feel better but then the pain completely subsided. I now am able to exercise without the fear that I will tear a ligament and am pain free.”Ellipsis P
“Transparency, thoroughness, attention to detail, immediate, high quality, follow ups and follow through are just a few words that come to mind throughout my experiences with Palm Beach Regenerative Sport and Spine.”Milton L
