AVN Hip Stem Cell Treatment: How It’s Done…

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What is AVN?

AVN stands for avascular necrosis. This is also known as osteonecrosis. This is a disease where the stem and progenitor cells (repair crew) in bone can’t function and the bone begins to die off. The bone can collapse, which in the hip, can cause a square peg in a round hole. There is an AVN grading scale from 1-4 that’s discussed here (avascular necrosis staging).

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Our Hip AVN Procedure Avoids Invasive Surgery

We’ve been treating hip AVN with stem cells longer than anyone else in the U.S., and through the years, we’ve seen this procedure do some amazing things, and we’ve also seen its limits. We’ve also seen a few different attempts to copy the original injection-based stem cell procedure either by substituting invasive surgery or by injecting magic stem cells IV or blind. Hence, we wanted to show everyone what’s involved in the actual precise injection that we use to help heal an AVN hip lesion.

The Original Hip AVN Procedure Goes Way Back

While many of the areas that we treat with stem cells, like low-back discs, facet joints in the spine, hip arthritis, knee arthritis, knee ACLs, and so on, were invented by our clinic and were firsts in the world when they were performed, that’s not the case with Hip AVN treatment. In fact, the first injection-based treatments for this dreaded disease were first accomplished by Hernigou and Gangji way back in the ’90s.

The disease itself is awful. Basically, a portion of the hip bone begins to lose its structural integrity. While the treatment is usually a major surgery to bore a big tunnel in the hip or to replace the joint, we’ve seen amazing results with just injecting stem cells into the lesion without significant surgery. Having said that, the original minimally invasive AVN hip stem cell treatment has been altered a bit to make it more or less invasive, so let’s look at those two variations.

If an Injection of Stem Cells into the Dying Hip Bone Works, Why Not Just Add Stem Cells into an Invasive Surgery?

As discussed, the procedure that we’ve been using for many years and the one described way back in the ’90s was to inject stem cells precisely under X-ray guidance into the AVN lesion in the femoral head. However, a few surgeons, not comfortable with this type of injection procedure, have begun to add stem cells into their usual Core Decompression Procedure. Why might this be an issue?

Medicine evolves from more to less invasive procedures for one simple reason: less invasive procedures produce fewer side effects and complications. In the case of an AVN hip stem cell treatment, the least invasive way to get stem cells into the bone lesion is through injection. So if that works, why take the risk of drilling a much bigger tunnel through the bone? There is no good reason, and one patient’s experience may tell us why there may be issues with that idea.

A few years back, I evaluated a patient with an AVN lesion of the hip who was interested in getting an injection of stem cells into the bone. However, for financial reasons, he chose to have a Core Decompression Surgery because the surgeon told him that she would just add stem cells with the surgery. He never got better and recently came in to be reevaluated for the issue. I was dumbfounded by his new MRI, as the lesion not only hadn’t gone away but had been replaced by a larger and over time growing area in the bone that looked very strange. In all of my years using the injection-based AVN hip stem cell treatment, I had never seen this type of growing lesion. The procedure either works to get rid of the dying bone, or if the condition is too far gone, it doesn’t work. I told him that while we would try to treat him at this late date, I was less certain of a positive outcome than I would have been if we had just treated his disease through a stem cell injection a few years back.

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The Magic IV or Blind Stem Cell Clinic

One recent stem cell treatment trend I’ve seen for hip AVN is that the patient is offered an IV infusion of usually fat stem cells or a blind injection of the joint. In fact, we had one such patient last year who had been given an IV infusion and then had the hip joint injected, blind without guidance. This therapy obviously didn’t work as the lesion is in a specific part of the hip bone and must be precisely targeted with stem cells.

The Real AVN Hip Stem Cell Injection Procedure

Hip AVN which is expressed in Arco 1-4, is time sensitive. Our intervention can save the Hip of young people who developed Hip AVN from a simple course of IV steroids for an asthma issue as a child, if we intervene in time!  

To show patients what the actual procedure looks like and how precise and technically demanding it is, we recently filmed a a quick look at a Regenexx Hip AVN procedure. The video is above. Note a few things about this injection-based AVN hip stem cell treatment:

  • This injection is a highly precise targeting of the bone lesion using C-arm fluoroscopy.
  • It’s a true minimally invasive percutaneous injection and not major surgery.
  • The size of the needle used to inject the cells is a fraction of the diameter of the tool used to bore a tunnel through the bone in a surgical Core Decompression.
  • This therapy is a procedure that you must be highly skilled and well trained to perform.

The upshot? We’ve likely treated more patients with an injection-based AVN hip stem cell treatment than any clinic or medical group in the U.S. The procedure can produce spectacular results in the right patients and provides limited benefit for the wrong patients. We wanted our readers to see how the injection is correctly performed and why adding magic stem cells into an existing surgery or injecting those cells IV or blind is either way too invasive or completely ineffective.

This blog post provides general information to help the reader better understand regenerative medicine, musculoskeletal health, and related subjects. All content provided in this blog, website, or any linked materials, including text, graphics, images, patient profiles, outcomes, and information, are not intended and should not be considered or used as a substitute for medical advice, diagnosis, or treatment. Please always consult with a professional and certified healthcare provider to discuss if a treatment is right for you.

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22 thoughts on “AVN Hip Stem Cell Treatment: How It’s Done…



    1. Regenexx Team Post author

      Are you inquiring about the procedure itself, or healing time?

  2. Eveline Eilert

    In the above article about AVN, in the last paragraph, please define who is the right patient and who is the wrong patient?

    Thank you.

    1. Regenexx Team Post author


      That’s done on a case by case basis. We’d need to look at your films and get you on the phone. If you’d like to see if you’re a Candidate, please submit the Candidate form: https://regenexx.com/the-regenexx-procedures/hip-surgery/

  3. Debbie

    Is this done under general anesthetic? I’ve been told to never have that again.

    1. Regenexx Team Post author

      No, we don’t use general anesthesia, but the patient is kept comfortable.

  4. Dan Angel

    Will my Insurance company or Medicare help pay for this procedure? and what’s the cost?.

    1. Regenexx Team Post author

      Stem Cell procedures are not covered by any type of insurance in the US. Cost depends on the treatment plan, so we’d need to see what needs to be done in your case. The Candidate form is here: https://regenexx.com/the-regenexx-procedures/hip-surgery/

  5. Bill Shipley

    What does AVN stand for?

    1. Regenexx Team Post author


      Avascular Necrosis. This means that the bone has died off, which often leads to collapse of the structure and then usually severe arthritis in the joint that’s closest to the bone. It occurs often in the hip, but can affect any bone, most commonly, the long bone (humerus) of the arm, knee, shoulder, ankle.

  6. Robin

    How many treatment or how many injection is needed to be done for avn oh the hip stage 3 ??

    1. Regenexx Team Post author

      It really depends on your particular case. Stage 3 hip AVN puts you in a category, but to determine what the treatment plan for your individual situation would require going through your MRI’s and medical history with you. If you’d like us to do that, please submit the Candidate form. Here’s an example: https://regenexx.com/hip-avn-surgery-alternative/

  7. Jaswinder kair

    Dear sir we are interested to go for a avn stem cell surgery please tell us the comp procedure

    1. Regenexx Team Post author


      We treat AVN with the patient’s own bone marrow stem cells in a very specific precise image guided injection based procedure.The stem cells are harvested form the patient’s iliac crest (the back of the hip. ) Please see: https://regenexx.com/blog/avn-hip-stem-cell/ There is specific Candidacy Criteria for an AVN procedure. If you would like to see if your particular case would be a Candidate, please submit the Candidate form.

  8. kathy mchugh

    How many patients have been treated with your stem cell technique for AVN. What results do you have for Stage I, Stage II A, Stage II B, Stage III C, Stage III.? Is the size of the lesion the most important determining factor for success? What percentage of femoral head damage significantly lessens your success rate? Does the location of the lesion determine success or not…medially vs. lateral AVN of femoral head? thank you

    1. Regenexx Team Post author


      We’ve treated several hundred AVN patients. The procedure works best in ARCO stage 1 and ARCO stage 2. You can set up a Candidacy Evaluation for more detailed discussion with Dr. Centeno by submitting the Candidate form here. http://www.regenexx.com

  9. Gem

    How about leukemia patient in remission can they use their own stem cell for this procedure? I am newly diagnosed of AVN w/c is the adverse effect of chemotheraphy, radiation and prednisone.

    1. Regenexx Team Post author

      If remission is 5 years cancer free, then yes. We’d need more information on the AVN through the Candidacy process. There is a Candidate form to the right of the blog.

  10. Ravindra Talekar

    I have Avn in both hips .in left hip its 3rd stage and right 2 nd stage can it be cured and if yes let me know how much it costs and in how many days i wil be cured 100%
    Please let me know

    1. Chris Centeno Post author

      ARCO grade 2 has a high cure rate, grade 3 less so. This disease can advance quickly, so treatment sooner rather than later is a priority. You should contact the call center number on the main website to find a doctor near you on our network that does this procedure.

  11. Giani Urena

    Question ,am planning to to do stem Cells next month with a doctor from regenexx ,on my hips ,they not collapse have a a little bit of necrosis , should I go to Cayman island to do it?

    1. Regenexx Team

      Hi Giani,
      We’d need more information through a Candidacy review to answer that question. What stage of AVN? Who is the procedure scheduled with?

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