Avascular Necrosis of the Femoral Head Avascular necrosis of the femoral head (AVN) is an increasingly common cause of musculoskeletal disability, and it poses a major diagnostic and therapeutic challenge. Although patients are initially asymptomatic, AVN usually progresses to joint destruction, requiring total hip replacement, usually before the fifth decade, It is a pathologic process that results from interruption of blood supply to the bone due to traumatic or nontraumatic factors. What is Avascular Necrosis? Avascular necrosis (also referred to as aseptic necrosis or osteonecrosis) as the name suggests is a condition that results from poor blood supply to an area of bone causing bone death. This necrosis due to loss of blood supply is more common in the neck of femur than other bones due to its peculiar blood supply. This is a serious condition because the dead areas of bone do not function normally, are weakened, and can collapse. AVN is extremely rare in healthy individuals. AVN only occurs in fatty marrow, which contains a sparse vascular supply. Lateral Epiphyseal Arteries Postero - Superior Retinacular Arteries Lateral Circumflex A Femoral_A Medial Circumflex A