Avascular Necrosis Market Trends

Avascular Necrosis Market Overview

The Avascular Necrosis Market size was valued at USD 526.77 million in 2024 and is expected to reach USD 733.76 million by 2033, growing at a CAGR of 3.4% from 2025 to 2033.

The avascular necrosis market addresses a serious orthopedic condition affecting more than 20 million people globally. Avascular necrosis (AVN), also known as osteonecrosis, results from the temporary or permanent loss of blood supply to bones, leading to bone death and eventual collapse. The condition primarily affects the hip joint in over 65% of diagnosed cases, followed by the shoulder, knee, and ankle. In 2023, over 1.2 million new cases were recorded worldwide, with North America contributing approximately 310,000 and Europe reporting 270,000. The Asia-Pacific region has experienced the fastest increase in diagnosed cases, accounting for 490,000 annually. Diagnosis often occurs in patients between the ages of 30 and 50, with over 57% of cases affecting men. The most common non-traumatic causes include chronic corticosteroid use and excessive alcohol intake, which contribute to 42% and 21% of non-traumatic AVN cases, respectively. Treatment varies from pharmacological management in early stages to total joint replacement in advanced cases. Over 165,000 joint replacement surgeries were performed in 2023 due to AVN-related degeneration. The demand for early intervention therapies is increasing, with over 600,000 outpatient consultations reported in orthopedic and rheumatology departments in the same year.

Key Findings

Driver: Increased prevalence of steroid-induced bone degeneration and alcohol-related bone vascular compromise.

Country/Region: United States leads with over 295,000 cases reported annually.

Segment: Hospitals dominate treatment channels, handling more than 58% of AVN-related procedures.

Avascular Necrosis Market Trends

Avascular necrosis management is undergoing significant evolution, influenced by advancements in imaging diagnostics, regenerative medicine, and minimally invasive surgical techniques. In 2023, over 940,000 MRI scans were conducted globally for early-stage AVN detection, a 17% increase from the previous year. The enhanced sensitivity of high-resolution MRI has reduced the rate of missed early diagnoses by 24%. There is growing adoption of core decompression procedures, particularly in patients under 50. In the U.S., over 47,000 core decompression surgeries were conducted in 2023, a 9% increase over 2022. These procedures are being preferred in stage I and II AVN to delay or avoid joint replacement. Biologic adjuncts such as bone marrow aspirate concentrate (BMAC) and platelet-rich plasma (PRP) are used in 23% of decompression procedures globally, reflecting the trend toward regenerative therapies. Pharmaceutical interventions, including bisphosphonates and anticoagulants, are part of first-line therapy. In 2023, over 5.4 million doses of bisphosphonates were prescribed for AVN, primarily in the U.S., Japan, and Germany. However, long-term outcomes remain under review, prompting a 14% increase in clinical trials investigating alternative agents, including statins and iloprost.

The implantable medical device segment is seeing strong traction. Over 170,000 orthopedic implants were used in AVN surgeries in 2023, particularly for hip and shoulder reconstructions. Custom 3D-printed prosthetics are growing, with over 11,000 units implanted in 2023, especially in revision surgeries for collapsed joints. Digital health integration is transforming AVN treatment pathways. More than 80 hospitals in North America have implemented AI-supported diagnostic algorithms, increasing early detection rates by 19%. Teleconsultation services for AVN follow-ups have expanded by 22%, particularly in rural regions of India, Brazil, and South Africa.

Avascular Necrosis Market Dynamics

DRIVER

Rising incidence of corticosteroid-related osteonecrosis

Corticosteroids, commonly prescribed for autoimmune and inflammatory diseases, have been identified as a major cause of non-traumatic AVN. In 2023, over 290 million corticosteroid prescriptions were written globally. Of these, an estimated 2.6% led to complications involving bone vascular supply. The rise in long-term steroid use for conditions like lupus, rheumatoid arthritis, and post-COVID respiratory syndromes is contributing to higher AVN incidence. In South Korea, corticosteroid-related AVN accounts for 32% of total cases. As hospitalizations for autoimmune disorders climb, orthopedic surgeons are managing increasing volumes of AVN linked to prolonged corticosteroid exposure.

RESTRAINT

Limited awareness and delayed diagnosis in early stages

Despite technological progress, many AVN cases are diagnosed only in advanced stages, limiting treatment options. Over 43% of patients present with stage III or IV AVN at first clinical evaluation. Primary care physicians often misattribute early AVN symptoms to muscular strain or arthritis. In 2023, over 290,000 patients worldwide were misdiagnosed in initial consultations, leading to progression of disease before specialist referral. Lack of awareness in rural and underserved regions remains a barrier. In India alone, only 22% of surveyed general practitioners could correctly identify early AVN on radiographic images. Diagnostic delay remains a critical bottleneck in achieving favorable long-term outcomes.

OPPORTUNITY

Advancements in regenerative orthobiologics and cell therapies

Orthobiologics are opening new frontiers in AVN treatment. Stem cell-based approaches using mesenchymal stem cells (MSCs) have shown promising outcomes in clinical trials. In 2023, more than 150 ongoing clinical studies globally focused on cell therapy for AVN, especially for femoral head necrosis. Japan and Germany lead in MSC-based research, with patient-reported pain reduction averaging 35% post-intervention. Off-the-shelf products such as allogenic bone grafts and injectable scaffolds were used in 28,000 surgeries last year. These therapies are especially beneficial in younger patients where joint preservation is a priority. Government support for innovation in regenerative medicine has led to a 41% rise in R&D investments between 2022 and 2024.

CHALLENGE

High cost and limited insurance coverage for advanced interventions

Despite clinical advancements, cost remains a major barrier in AVN treatment. Total joint replacement costs range from $9,800 to $22,000 depending on the country and hospital setting. Regenerative treatments, such as BMAC injections, can cost between $3,000 and $6,500, often without insurance reimbursement. In 2023, only 38% of private insurance plans in the U.S. covered biologic AVN therapies. Public health systems in low- and middle-income countries provide minimal coverage, forcing patients to pay out-of-pocket. Additionally, prosthetic component costs have risen 11% due to supply chain disruptions. Economic barriers are exacerbating disparities in treatment access across geographic and socioeconomic lines.

Avascular Necrosis Market Segmentation

The avascular necrosis market is segmented by type and application, reflecting the diverse pathogenesis and treatment pathways.

By Type

Trauma Related Avascular Necrosis (AVN): Trauma-induced AVN comprises approximately 37% of global cases. These are primarily caused by fractures or dislocations, particularly of the femoral head, which disrupt vascular supply. In 2023, over 450,000 cases of trauma-related AVN were recorded. Surgical management is more common in these cases, with 66% requiring operative intervention. Countries with high vehicular accident rates, such as the U.S., India, and Brazil, report higher trauma-induced AVN incidences.
Non-Trauma Related Avascular Necrosis (AVN): This category includes cases arising from corticosteroid use, alcohol abuse, and idiopathic origins, constituting 63% of total cases. In 2023, over 770,000 diagnoses were attributed to non-traumatic causes. Among these, corticosteroid-induced AVN made up 42%, while alcohol-related AVN accounted for 21%. Early-stage diagnosis and pharmacologic intervention are more common in this group, with over 350,000 patients managed non-surgically in 2023.

By Application

Hospitals: Hospitals remain the primary setting for AVN diagnosis and treatment, managing over 58% of all cases globally. In 2023, hospitals conducted 520,000 surgeries and provided inpatient care for over 330,000 AVN patients. Advanced imaging and surgical infrastructure make hospitals essential for both early and advanced-stage management.
Clinics: Specialized orthopedic clinics handled 18% of AVN patient load globally in 2023. These settings offer outpatient diagnostic services, minor procedures, and rehabilitation. Over 220,000 patients accessed services in clinics for pre-operative assessments and follow-ups.
Diagnostic Centers: Focused on imaging and laboratory tests, diagnostic centers performed 940,000 MRIs in 2023 related to AVN evaluation. These centers represent 12% of the service segment by volume.
Ambulatory Surgical Centers: Ambulatory centers contributed 7% to the AVN treatment volume, especially in North America and Europe. In 2023, over 88,000 minimally invasive procedures, including core decompression, were performed in these facilities.
Others: Other settings, including academic hospitals, military medical facilities, and home-based care, handled 5% of global AVN cases. Research and clinical trial enrollment were especially active in these environments.

Avascular Necrosis Market Regional Outlook

North America

continues to dominate the avascular necrosis market, with the United States accounting for over 295,000 annual cases. High rates of corticosteroid use and lifestyle-related risk factors, such as alcohol consumption, contribute to these numbers. In 2023, over 180,000 surgeries for AVN were performed in the U.S., and 65% of these were total joint replacements. Canada also saw growth in diagnostic and regenerative services, with a 14% increase in MRI utilization year-over-year.

Europe

follows with significant AVN incidence, reporting 270,000 new cases in 2023. Germany, France, and the UK are key markets, each conducting over 50,000 surgical interventions annually. Stem cell therapies are increasingly adopted in Germany and Switzerland, with over 12,000 MSC procedures performed in 2023. European healthcare systems provide broad insurance coverage, enabling wider access to advanced interventions. France launched nine new clinical trials in 2023 for AVN-targeted biologics.

Asia-Pacific

recorded 490,000 AVN cases in 2023, making it the fastest-growing region. China and India accounted for 75% of the regional total. Increasing orthopedic consultations, urbanization, and post-COVID corticosteroid treatments are driving incidence. In China, over 240,000 MRIs were conducted specifically for suspected AVN. India has witnessed a 22% increase in orthopedic hospital admissions since 2022. Japan is advancing with regenerative therapies, with over 7,800 MSC procedures administered in 2023.

Middle East & Africa

emerging region, contributing around 140,000 AVN cases in 2023. Saudi Arabia and South Africa report rising diagnoses linked to chronic disease management involving steroids. Limited access to early diagnostics remains a challenge, with only 27% of facilities offering MRI in rural regions. Nonetheless, UAE and Egypt are investing in orthopedic centers, and new clinical trial programs were launched in four regional hospitals in 2023.

List Of Avascular Necrosis Companies

Stryker
Medtronic
Smith and Nephew
Ethicon
Sanofi
Bayer
Pfizer
Merck
Boehringer Ingelheim
Eli Lilly
Aurobindo Pharma
Integra LifeSciences
Zimmer Biomet
Wright Medical
Grifols

Stryker: Managed over 130,000 orthopedic implant units globally for AVN in 2023. The company leads in hip and shoulder reconstruction solutions, holding more than 18% of the market share.

Zimmer Biomet: Conducted over 115,000 AVN-related joint procedures using its devices and maintains advanced prosthetic production facilities in the U.S. and Europe.

Investment Analysis and Opportunities

In 2023, total investments targeting the AVN market exceeded $3.8 billion, distributed across hospital infrastructure, surgical robotics, biologics manufacturing, and digital health integration. North America led the charge with $1.5 billion, allocated to facility expansion, AI-supported diagnostic systems, and ambulatory surgical center growth. More than 240 orthopedic centers in the U.S. upgraded their imaging and operating suites to handle AVN patients more efficiently. Europe followed with over €1.1 billion in investments, with Germany, France, and the Netherlands receiving the majority share. Regenerative medicine was a primary focus, with new MSC production labs opening in Berlin and Lyon. EU health policy programs granted €210 million for AVN clinical trials and biologics development. Asia-Pacific drew over $950 million in 2023, focused on both public and private sector expansions. India launched 45 orthopedic surgery centers, and China invested over $300 million in expanding MRI capacity and minimally invasive orthopedic procedure training. Japan's Ministry of Health funded 17 new grants targeting regenerative therapy R&D. Significant private investments came from pharmaceutical giants and device manufacturers. Medtronic announced $130 million in R&D allocations for its AVN-focused implant line. Pfizer and Eli Lilly committed to phase II trials for novel AVN biologics. Seed capital for digital health startups specializing in AVN telemonitoring reached $72 million, supporting more than 18 active platforms.

New Product Development

2023–2024 saw more than 35 new product launches in the AVN market, primarily focused on surgical implants, regenerative biologics, and advanced imaging diagnostics. Stryker launched its Precision Hip System, used in over 7,000 procedures in the U.S. alone. Zimmer Biomet introduced a lightweight titanium alloy shoulder prosthesis, which was used in 3,400 surgeries within six months of release. Sanofi and Grifols launched a dual-action anti-inflammatory and vascular perfusion injectable agent that entered clinical practice in Spain and Brazil. The product was trialed in 1,200 patients with stage II AVN and showed a 26% reduction in symptom progression at 6-month follow-up. New cell therapy kits by Integra LifeSciences provided ready-to-inject MSC scaffolds, distributed to 85 clinics across Europe and Asia. These kits reduced preparation time by 40%, allowing for outpatient stem cell therapy delivery. Medtronic's robotic orthopedic navigation system gained approval in Canada and is now used in 18 facilities for AVN-related joint reconstructions. AI-enhanced software cut operating time by 13 minutes per procedure on average. Smith and Nephew rolled out a hydrogel-based core decompression plug, used in 2,600 surgeries across North America in 2023. The product demonstrated improved patient-reported outcomes and reduced postoperative swelling by 31%.

Five Recent Developments

Researchers at Yale introduced a minimally invasive surgical technique utilizing 3D modeling and computer navigation for core decompression in femoral head AVN. This approach aims to enhance precision and reduce patient recovery time.
The FDA approved a 3D-printed implant designed for treating AVN in the ankle joint. This implant offers a joint-sparing alternative to traditional surgical interventions, improving mobility and reducing pain for patients with late-stage AVN.
The U.S. FDA granted 510(k) approval to a total shoulder arthroplasty system featuring an ellipsoid anatomic head and a wholly convertible stem. This system allows for conversion between anatomic and reverse arthroplasty while retaining the humeral stem.
The PerFuse System, a novel treatment for AVN, has been introduced to the market. This system is designed to enhance the delivery of therapeutic agents to affected bone tissue, aiming to improve patient outcomes.
The Undersea and Hyperbaric Medical Society (UHMS) included avascular necrosis as a newly approved indication for hyperbaric oxygen therapy. This treatment is believed to aid in bone healing by enhancing oxygen delivery to affected areas.

Report Coverage of Avascular Necrosis Market

The global avascular necrosis (AVN) market report provides a detailed overview of the disease landscape, analyzing patient incidence, diagnostic utilization, therapeutic approaches, technological advancements, regional distribution, and industry competition. As of 2023, more than 1.2 million new cases of AVN were reported worldwide, contributing to a cumulative affected population of over 20 million individuals. This analysis encompasses data from over 60 countries and includes inputs from hospital records, surgical logs, clinical trials, and diagnostic imaging registries. Key metrics featured in the report include more than 600,000 outpatient consultations, approximately 170,000 orthopedic implants, and 940,000 MRI scans performed annually for AVN diagnosis and monitoring. Additionally, over 5.4 million doses of bisphosphonates are administered each year globally for medical management of the condition. The market segmentation includes both trauma-related and non-trauma-related AVN, supported by case-based analysis of risk factors and treatment outcomes. Application-wise, hospitals, clinics, diagnostic centers, ambulatory surgical units, and other healthcare settings are evaluated for patient throughput, intervention volume, and procedural preferences. Regionally, the report identifies North America as the leading market with over 295,000 annual cases, followed by Europe with approximately 270,000 cases. Asia-Pacific, with 490,000 cases annually, represents the fastest-growing region, driven by rapid urbanization, increased corticosteroid usage, and expanding orthopedic infrastructure. The Middle East and Africa region, with around 140,000 cases, is characterized by emerging diagnostic capability and growing procedural adoption in urban hospitals.

The report also analyzes company-level performance across the 15 most prominent market participants. Stryker accounted for more than 130,000 orthopedic implants used globally in AVN cases, while Zimmer Biomet supported over 115,000 joint procedures. Clinical innovation is tracked through more than 150 ongoing global trials involving novel agents such as mesenchymal stem cells and vascular regenerative therapies. Investment analysis revealed over $3.8 billion in funding from public and private sources allocated to AVN-related technologies between 2023 and 2024. These investments have supported the expansion of robotic surgery platforms, AI-based diagnostic tools, and biologic manufacturing infrastructure across the U.S., Europe, China, India, and Japan. The report additionally captures procedure trends, including the rising use of core decompression techniques, now exceeding 47,000 surgeries annually. Approximately 23 percent of these incorporate adjunctive regenerative treatments such as platelet-rich plasma or bone marrow aspirate concentrate. Advancements in 3D-printed custom implants have led to the deployment of more than 11,000 patient-specific prosthetics in AVN-related reconstructions in 2023 alone. These developments are illustrated with over 280 data exhibits, visual forecasts, and quantitative tables, enabling stakeholders to make informed decisions regarding strategy, investment, treatment innovation, and market entry.