Can Osteonecrosis be prevented?
Yes, to some extent. Modifiable risk factors can be manipulated, for example, steroid dose, alcohol intake, and control of diabetes and hyperlipidemia. As an example, the vast majority of cases of corticosteroid-related ON occur in patients who have received the equivalent of ≥20 mg of prednisone/day, especially for prolonged periods. In rheumatoid arthritis, where prednisone doses rarely exceed 10 mg/day, ON is uncommon. By contrast, in SLE, in which higher doses of steroids are frequently used, 30% to 50% of patients may develop some degree of ON. Early use of lipid-lowering drugs, bisphosphonates, antioxidants (vitamin E), and anticoagulants may be preventative.
