[1] Most of the time surgery is eventually required and may include core decompression, osteotomy, bone grafts, or joint replacement.

[1] Prolonged, repeated exposure to high pressures (as experienced by commercial and military divers) has been linked to AVN, though the relationship is not well understood.

[17] The hematopoietic cells are most sensitive to low oxygen and are the first to die after reduction or removal of the blood supply, usually within 12 hours.

[2] Under favorable conditions, the remaining inorganic mineral volume forms a framework for establishment of new, fully functional bone tissue.

In later stages it appears relatively more radio-opaque due to the nearby living bone becoming resorbed secondary to reactive hyperemia.

Another named form of AVN is Köhler disease, which affects the navicular bone of the foot, primarily in children.

However, THRs have a number of downsides, including long recovery times and the lifespans of the hip joints (often around 20 to 30 years).

[22] THRs are an effective means of treatment in the older population; however, in younger people, they may wear out before the end of a person's life.

[23] Bisphosphonates, which reduce the rate of bone breakdown, may prevent collapse (specifically of the hip) due to AVN.

[11] The disease's progression may be halted by transplanting nucleated cells from the bone marrow into avascular necrosis lesions after core decompression.

If left untreated, the disease progresses, the bone collapses,[28] and the joint surface breaks down, leading to pain and arthritis.

[29] Avascular necrosis of the hip was also identified in a routine medical check-up on quarterback Brett Favre following his trade to the Green Bay Packers in 1992.

[citation needed] Another high-profile athlete was American road racing cyclist Floyd Landis,[31] winner of the 2006 Tour de France, the title being subsequently stripped from his record by cycling's governing bodies after his blood samples tested positive for banned substances.

[33] Rafael Nadal successfully continued his tennis career after having surgery for Mueller–Weiss syndrome (osteonecrosis of the navicular bone in the foot).