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Avascular necrosis (AVN) is a condition in which the subchondral bone (bone beneath the cartilage of a joint) dies from an interruption its blood supply. Once the bone dies, it is unable to maintain itself and it eventually fractures and collapses under the physiologic (normal) but significant compressive forces across the joint. This death and fracturing of the bone is associated with symptoms of pain. Often, surgery is necessary to stimulate the bone to re-vascularize and heal and/or repair/replace missing bone to support the joint surface. Avascular necrosis is associated with proximal humerus fractures, dislocations, repetitive trauma, compromised blood supply following injury, and prolonged steroid use.
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