Osteonecrosis of the Hip from Trauma in an Accident

Osteonecrosis of the hip is a medical condition characterized by the death of bone cells following impaired blood flow to the bone. Also known as aseptic necrosis or avascular necrosis (AVN), most cases occur in the femoral head (hip joint). Osteonecrosis may also occur in other anatomical positions, such as the ankle, knee, and shoulder. The disease may progress within months or a year. It is commonly caused by trauma, such as a dislocation or fracture. Avascular necrosis may also be idiopathic, meaning the condition may develop without any known causative factor.

Avascular necrosis may develop from injuries like a fracture or dislocation. If you developed hip osteonecrosis due to an accident caused by negligence, you may be entitled to compensation. Call (916) 921-6400 or (800) 404-5400 for free, friendly advice from our California personal injury lawyers.

When considering legal action after getting injured in an incident through no fault of your own, working with a personal injury law firm with a track record of success is essential. At AutoAccident.com, our California personal injury attorneys have decades of combined experience handling accident cases. We are committed to putting our clients’ goals and needs first, providing compassionate support, and obtaining successful case results on their behalf. Learn how we can assist you with your traumatic osteonecrosis case by scheduling a free consultation today.

Osteonecrosis is categorized as traumatic, meaning after an injury, or non-traumatic. Traumatic avascular necrosis is common and is often the result of a displaced fracture where the bone is broken into two or more fragments resulting in misalignment. A bone dislocation or a displaced fracture may impair blood flow in the femoral head leading to death in this area of the bone. Non-traumatic osteonecrosis may occur without injury or direct trauma. It may develop from a condition or disease that impairs blood flow in various areas of the bone. This disorder tends to affect males more than their female counterparts.

Around 10,000 to 20,000 individuals develop avascular necrosis in the United States each year. Both males and females are affected by AVN, and it may develop in people of all ages. However, it tends to be more common in individuals in their 30s and 40s.

Case studies have suggested that avascular necrosis may start before the experience of symptoms. Patients may feel pain in the affected hip and persistent or worsening pain. Clinical findings may include flattening of the femoral head, subchondral collapse, narrowing of the hip joint space with or without the involvement of the femoral head, and advanced degenerative changes. The progression of symptoms is attributed to the presence or absence of bone marrow edema (BME). Patients with end-stage disease may experience joint collapse, debilitation, and severe pain.

The presentation of osteonecrosis is greatly variable. Therefore, it is recommended that patients decrease their risk factors for non-traumatic osteonecrosis, including the avoidance of tobacco use and excessive alcohol consumption. Lowering or minimizing the use of corticosteroids may also decrease the risk of developing AVN. Other risk factors may include long-term use of bisphosphonates, hyperlipidemia, autoimmune connective tissue disorders, radiotherapy, and blood disorders like sickle cell disease. Approximately 20 percent of hip osteonecrosis cases are caused by idiopathic avascular necrosis.

Non-surgical treatments are intended to relieve symptoms of avascular necrosis. This may include physical therapy, decreasing physical activity and stress like weight bearing for AVN of the knee and hip, and taking pain relievers, such as anti-inflammatory medications. If the affected area is small or in cases where it is found early and before it develops into advanced osteonecrosis, the condition may heal without treatment. Non-surgical management may be adequate for treating small areas of avascular necrosis of the hip, knee, and shoulder.

Various surgeries may be performed if non-surgical management, such as pain relievers, physical therapy, and rest, is ineffective in relieving symptoms. Surgical procedures are recommended to slow or potentially prevent the progression of osteonecrosis. They are most effective in treating early avascular necrosis and are performed to preserve the joint. This is especially true in cases involving the hip where the bone has not yet collapsed. In cases involving bone collapse, joint replacement procedures may be performed to improve function and decrease pain.

Osteonecrosis cases where non-surgical treatments have failed may require surgery if the condition worsens. Surgical management of avascular necrosis may include the following procedures:

• Arthroplasty: Also referred to as a total joint replacement, this procedure effectively restores motion and relieves the pain if AVN has resulted in osteoarthritis and significant joint collapse. A partial or total joint replacement may be indicated if non-surgical management is unsuccessful in advanced cases.
• Bone Grafting: In osteonecrosis cases, vascularized bone grafting seeks to defer the timing for arthroplasty. It is often used in treating early post-collapse and pre-collapse from avascular necrosis of the femoral head.
• Core Decompression: The most common procedure for treating osteonecrosis is core decompression. It stimulates bone healing, promotes blood flow, and reduces pressure through perforations. However, around 20 to 35 percent of cases involving core decompression may require a total hip replacement.
• Osteotomy: Another procedure to salvage an affected joint is an osteotomy. This procedure is recommended for patients deemed poor candidates for core decompression due to the extent of collapse.

Dealing with a painful condition like AVN may be challenging. Effective management starts with prompt medical care followed by support groups and assistance from a mental health professional if needed.

Advanced avascular necrosis may result in permanently decreased mobility and osteoarthritis due to joint deterioration. Severe osteonecrosis cases may require arthroplasty (joint replacement surgery). Complications that may commonly occur after surgery include neurovascular compromise, prosthesis malfunctions, and surgical site infections.

Patients with comorbidities may also face a higher risk of complications. Case studies have reported that patients with sickle cell disease who have received a total joint replacement for avascular necrosis had an overall higher rate of mortality. Others included myocardial infarction, deep vein thrombosis, pulmonary embolism, implant failure, increased chance of acute kidney injury, and prolonged hospitalizations.

Traumatic osteonecrosis may occur from a hip fracture or dislocation caused by an accident. If this condition developed following an incident caused by someone else’s negligence, an injured party may be entitled to compensation for their losses. This is accomplished through a claim against the at-fault party and their insurance carrier. When the person responsible for the crash has insufficient or no insurance, a claim through uninsured and underinsured motorist coverage may be in order.

Eligible claimants may recover economic and non-economic damages, like permanent injury or disability, pain and suffering, wage loss, medical bills, etc. Clear and compelling evidence must demonstrate the connections between the accident, the hip dislocation or fracture, and the development of AVN. Injured parties must seek immediate medical care, avoid gaps in treatment, and follow physician orders. Failure to do so may result in the insurer denying a claim for damages.

Insurance companies are focused on paying the lowest amounts on bodily injury claims. As such, it is essential to retain legal counsel if an accident leaves you injured, especially if you sustained a bone fracture or dislocation. Injuries like these can potentially progress to avascular necrosis and other debilitating conditions. A California accident attorney can help you in your case by:

• Providing support and guidance
• Assessing the personal injury case
• Collecting and preserving evidence
• Conducting an in-depth investigation
• Identifying all potentially negligent parties
• Handling communication and negotiations with insurers
• Filing the matter in court to protect the statute of limitations
• Preparing for litigation if a settlement agreement is not reached
• Advocating for the client’s rights in court if the case goes to trial

When dealing with osteonecrosis of the hip after suffering a bone dislocation or fracture in an accident, working with an injury lawyer with experience handling cases like yours is helpful. Here at AutoAccident.com, we have helped California residents since 1982. Learn about our services and how we can assist you with your avascular necrosis of the hip case by watching this video or setting up a free case evaluation today.

Avascular necrosis of the hip is a painful condition that may be idiopathic or caused by trauma in an accident. If you developed osteonecrosis of the hip due to a fracture or dislocation suffered in an incident caused by negligence, contact our experienced California personal injury lawyers for free, friendly case advice at (916) 921-6400 or (800) 404-5400. Here at AutoAccident.com, our legal team is dedicated to securing successful resolutions through verdicts and settlements on behalf of our clients, and we can do the same for you and your hip osteonecrosis case.

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