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How can osteonecrosis eventually lead to osteoarthritis in a joint?
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bone disease
Defect of tibia, caused by septic osteomyelitis in childhood, with compensatory thickening of the fibula (right). Normal bones are shown at left.
When osteonecrosis affects the cancellous bone of the epiphyses (the ends of long bones), the body initiates a repair process to remove dead bone and form new tissue. If this rebuilding process weakens the bone structure, the bone may collapse under the mechanical forces exerted across the joint.1
This structural collapse leads to damage in the overlying joint cartilage. Once the cartilage is compromised, the joint loses its protective surface, which triggers the development of osteoarthritis. Because of this risk, early clinical management of osteonecrosis—particularly in weight-bearing joints like the hip and knee—often focuses on preventing the joint from bearing weight to avoid such mechanical failure.1