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Orthopedic Treatment For Knee Osteonecrosis

Last updated: February 7, 2026 Medically reviewed by: RxHarun Orthopedic Specialist Doctor Reading time: 2 min read

Death of a bone due to loss of blood supply is referred to as Osteonecrosis. The condition mostly affects the hip joint although the knees may also get damaged. It is one of the most common causes of knee pain in women above the age of 60 years. The knee joint gets its blood supply from the two main arteries: femoral artery and the popliteal artery. During Osteonecrosis, the blood supply to the lateral femoral condoyle or the medial femoral condoyle, two main bones of the thigh, may get disrupted. The top of the tibia or the lower leg bone may also be damaged. The bones thrive on uninterrupted blood supply just like the body tissues and they tend to die if it is disrupted. Over a period of time, the bones begin to disintegrate. The other joints that may also be affected are elbow, shoulder and ankle. Knee Osteonecrosis takes a few months or a year to progress to its last stage.

Causes

  • Trauma caused to the knee or leg
  • Bone density loss due to ageing may lead to secondary fractures and eventually Necrosis
  • Osteoporosis makes the bones of the joint prone to micro tears and fractures
  • Edema or fluid accumulation in the joint spaces post injury
  • Conditions such as Sickle cell disease, Caisson disease, Gaucher disease, Pancreatitis, etc.
  • Excessive alcohol consumption may increase the risk
  • Obesity
  • Surgical procedures for kidney transplant
  • Prolonged use of steroids
  • Lupus
  • Blood clots may block the flow of blood in the arteries
  • After-effects of radiation therapy

Symptoms

  • Considerable pain, particularly while sleeping or when the joint is stressed post activity
  • The onset of the pain may either be sudden or triggered by some causative factors
  • The joint may feel tender and sensitive when touched
  • Range of motion may be affected
  • Inflammation of the joint
  • Formation of bone spurs
  • Change in shape of the bones or joint
  • Altered gait

Diagnosis

  • Analysis of the patient’s medical history and symptoms
  • Palpation to check for inflammation and locate pain
  • Bone scans
  • X-ray imaging
  • MRI or CT scan may be recommended

Treatment

  • Pain killers and anti inflammatory medicines may be prescribed
  • The doctor may suggest to avoid weight bearing activities
  • A removable knee brace may be used for added support
  • The doctor may recommend activity modification at home and the workplace
  • Physical therapy to maintain and improve joint function and flexibility
  • Arthroscopic debridement of the joint
  • Total replacement of the joint, in case the disease has progressed to the last stages
  • Holes may be drilled into the affected bone to promote blood flow

Frequently Asked Questions

Is this article a replacement for a doctor?

No. It is educational content only. Patients should consult a qualified clinician for diagnosis and treatment.

When should I seek urgent care?

Seek urgent care for severe symptoms, rapidly worsening condition, breathing difficulty, severe pain, neurological changes, or any emergency warning sign.

References

Add references, clinical guidelines, textbooks, journal articles, or trusted medical sources here. You can edit this area later with a custom field named _rx_references.

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Written by Dr. Harun Ar Rashid, MD - Arthritis, Bones, Joints Pain, Trauma, and Internal Medicine Specialist

Dr. Md. Harun Ar Rashid, MPH, MD, PhD, is a highly respected medical specialist celebrated for his exceptional clinical expertise and unwavering commitment to patient care. With advanced qualifications including MPH, MD, and PhD, he integrates cutting-edge research with a compassionate approach to medicine, ensuring that every patient receives personalized and effective treatment. His extensive training and hands-on experience enable him to diagnose complex conditions accurately and develop innovative treatment strategies tailored to individual needs. In addition to his clinical practice, Dr. Harun Ar Rashid is dedicated to medical education and research, writing and inventory creative thinking, innovative idea, critical care managementing make in his community to outreach, often participating in initiatives that promote health awareness and advance medical knowledge. His career is a testament to the high standards represented by his credentials, and he continues to contribute significantly to his field, driving improvements in both patient outcomes and healthcare practices. Born and educated in Bangladesh, Dr. Rashid earned his BPT from the University of Dhaka before pursuing postgraduate training internationally. He completed his MD in Internal Medicine at King’s College London, where he developed a special interest in inflammatory arthritis and metabolic bone disease. He then undertook a PhD in Orthopedic Science at the University of Oxford, conducting pioneering research on cytokine signaling pathways in rheumatoid arthritis. Following his doctoral studies, Dr. Rashid returned to clinical work with a fellowship in interventional pain management at the Rx University School of Medicine, refining his skills in image-guided joint injections and minimally invasive pain-relief techniques.