Download Osteonecrosis or Avascular Necrosis

CCLG Aftercure Factsheet
Published in conjunction
with Aftercure: A guide
for teenage and young
adult survivors of
childhood cancer
Osteonecrosis or
Avascular Necrosis
Aftercure
A guide for teenage
and young adult
survivors of childho
od
cancer
www.aftercure.org
www.cclg.org.uk
The health of your bones after
childhood cancer treatment
Background
Who is at risk?
Osteonecrosis is a condition where there is a temporary
or permanent loss of blood supply to the bone. It is also
known by the term avascular necrosis (AVN). This can
weaken the bone and cause pain and stiffness (arthritis).
For some individuals, this weakness may progress to joint
problems and in the long term a joint replacement may be
needed. This progression may take place over many years.
The following treatments are associated with osteonecrosis:
Osteonecrosis is most likely to occur during treatment for
cancer. It can affect any bones but more often is found
in the ends of long bones such as the thigh bone causing
hip and knee problems. It can occur in one bone or in
many. Osteonecrosis may be found incidentally or when
investigations are performed as a consequence of bone
pain.
• corticosteroids
• total body irradiation
Teenagers and those with sickle cell disease are more at
risk than others receiving these treatments.
How is osteonecrosis diagnosed?
Your doctor will use some or all of the following tests to
investigate for bone and joint pain:
• X-ray
• ultrasound scan
• MRI scan
How is osteonecrosis treated?
Treatment for osteonecrosis aims to reduce pain, stop
bone damage and protect the joint from further damage. It
includes:
• painkillers – to reduce pain
• reduced weight bearing – to allow healing
• physiotherapy exercises – to encourage mobility
• surgical treatment – for severe cases to promote
healing or in advanced cases to reconstruct the joint
Other risk factors for osteonecrosis include:
• bisphosphonates
CCLG Aftercure Factsheet
What can I do?
Where can I find more information?
The following will help to relieve some of the symptoms
from osteonecrosis:
The (American) National Association of Arthritis and
Musculoskeletal Diseases and Skin Diseases has further
information about osteonecrosis
www.niams.nih.gov/health_info/osteonecrosis/
osteonecrosis_ff.asp
• regular exercise is important but care should
be taken when considering activities that put
stress on your joints eg. running and jumping
- discuss this with your clinical team
• do your physiotherapy exercises regularly
• rest your joints when they hurt
• make sure you maintain a healthy weight
Children’s Cancer and Leukaemia Group
University of Leicester
Clinical Sciences Building
Leicester Royal Infirmary
Leicester LE2 7LX
0116 252 5858
[email protected]
www.cclg.org.uk
ChildrensCLG
CCLG_UK
Registered charity number 286669
www.aftercure.org
The full range of factsheets for childhood and teenage
cancer survivors are available on the CCLG and Aftercure
websites in conjunction with CCLG’s booklet entitled
‘Aftercure: A guide for teenage and young adult survivors
of childhood cancer’.
Written by CCLG’s Late Effects Group, a national group
of experts who specialise in looking after children
and young adult cancer survivors, in conjunction
with the CCLG Publications Committee, comprising
multiprofessional experts in the field of children’s cancer.
© CCLG 2016
Published by CCLG January 2016
Next review date: January 2019
Children’s Cancer and Leukaemia Group is a leading
children’s cancer charity and the UK and Ireland’s
professional association for those involved in the
treatment and care of children with cancer. Each week in
the UK and Ireland, more than 30 children are diagnosed.
Two out of ten children will not survive their disease.
We bring together childhood cancer professionals to
ensure all children receive the best possible treatment
and care. We fund and support research into childhood
cancers, and we help young patients and their families
with our expert, high quality and award-winning
information resources.
If you have any comments on this factsheet, please
contact us.
CCLG publications on a variety of topics related to
children’s cancer are available to order or download free
of charge from our website.