Avascular Necrosis Shoulder

What is avascular necrosis, and how is it treated?

You may experience shoulder pain for a number of reasons. One reason can be due to a condition called avascular necrosis.

Our board-certified surgeons at OrthoNeuro can provide an accurate diagnosis and the appropriate treatment you need for relief. We are conveniently located in Columbus, Ohio. Schedule an appointment with us today!

What Is Avascular Necrosis of the Shoulder?

Avascular necrosis (AVN) of the shoulder is a condition in which the ball-shaped head of the humerus bone (upper arm bone) that fits into the socket of the shoulder joint gradually dies off due to the lack of blood supply. This can cause shoulder joint pain, limited range of motion, and other shoulder complications.

What Causes Avascular Necrosis of the Shoulder?

Avascular necrosis of the shoulder can be caused by injury or trauma to the joint, such as a dislocated shoulder or a shoulder fracture of the humeral head, which impedes blood flow to the bone tissue.

Diseases and medical conditions that affect the blood supply to the joints can include:

  • Sickle cell
  • Lupus
  • Vasculitis

Interestingly, roughly 20% of people with avascular necrosis have no apparent cause for the condition. However, there are several known risk factors that can contribute to shoulder AVN, including:

  • Certain medications, such as corticosteroids and chemotherapy drugs, have been linked to an increased risk of avascular necrosis in some individuals.
  • Excessive alcohol consumption
  • Smoking
  • Fatty deposits in blood vessels
  • Having a bone marrow transplant

What Are Some of the Symptoms of Shoulder Avascular Necrosis?

Symptoms of shoulder AVN occur when certain bone tissues in the shoulder die because the shoulder humeral head suffers a stroke resulting in the loss of blood supply.

Symptoms may include:

  • Pain that is initially dull but gradually becomes more severe
  • Pain or dysfunction when the humeral head collapses
  • Difficulty moving the affected arm and shoulder
  • Stiffness in the area
  • Shoulder clicking or popping sensations

If you’re experiencing symptoms related to avascular necrosis, it’s essential to talk to a shoulder specialist as soon as possible. They can help you determine the best course of treatment.

Shoulder AVN Diagnosis

To diagnose avascular necrosis, a healthcare provider may start with a physical exam, reviewing medical history, and assessing the symptoms like joint pain and stiffness. In terms of a physical exam, doctors may assess your range of motion, shoulder strength, as well as any pain or tenderness in the area.

Further imaging tests, such as X-rays, MRI, or bone scans, may be conducted to inspect the affected area in more detail and evaluate the extent of bone death (bone necrosis) and tissue death. Blood tests may also be required to check for underlying conditions that may have caused the avascular necrosis.

Getting a proper diagnosis early on is crucial, as early treatment can help prevent further damage and improve the chances of successful recovery. The exact diagnostic process may vary depending on the individual case, so it is vital to seek proper medical attention and follow the advice of a qualified orthopedic surgeon.

AVN of the Shoulder Treatment Options

There are several treatment options available for AVN of the shoulder, and the choice of treatment depends on the extent of the disease and your age.

Non-Surgical Treatments

One of the main goals of treatment is to prevent the progression of the disease and to alleviate pain. Conservative treatment can include nonsteroidal anti-inflammatory drugs (NSAIDs) and physical therapy. These methods can help reduce inflammation and improve mobility of the shoulder.

Some have also found stem cell therapy to be helpful in relieving pain.

Surgical Treatment

Surgical intervention may be required in more advanced cases of AVN. Some patients may benefit from a core decompression surgery, which involves removing a section of the dead bone tissue to reduce pressure and improve blood flow to the area.

Others may require a partial shoulder replacement. Still, others may need total joint replacement surgery, which involves replacing the affected joint with a prosthetic joint.

Schedule an Appointment with OrthoNeuro Today!

It’s important to note that successful treatment of AVN of the shoulder depends on early detection and prompt treatment.

If you are experiencing shoulder pain, do not hesitate to seek treatment. Schedule an appointment with us at OrthoNeuro in Columbus, OH today! We have multiple locations for your convenience.


Medically reviewed by B. Rodney Comisar, MD, FAAOS

Shoulder Specialists

IF YOU HAVE SEVERE SHOULDER PAIN AND STIFFNESS THAT PREVENTS YOU FROM MOVING YOUR SHOULDER CORRECTLY, CALL ORTHONEURO IN COLUMBUS, OHIO, OR REQUEST AN APPOINTMENT ONLINE FOR EXPERT ORTHOPEDIC SHOULDER TREATMENTS.
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