Shoulder Osteonecrosis (Avascular Necrosis)
Shoulder osteonecrosis, also called avascular necrosis, occurs when the blood supply to part of the humeral head is disrupted.
Shoulder osteonecrosis, also called avascular necrosis, occurs when the blood supply to part of the humeral head is disrupted. The bone can weaken beneath the cartilage and eventually collapse, producing pain, stiffness, deformity, and secondary arthritis.
Early disease may be visible on MRI before it appears on X-rays. Treatment depends on the stage, size and location of the lesion, symptoms, cartilage and socket condition, rotator cuff function, age, health, cause, and goals.
Observation and activity modification may be appropriate for selected early or minimally symptomatic disease. Core decompression can be considered before collapse in selected patients. Once the humeral head has collapsed or the joint is arthritic, treatment may require hemiarthroplasty, anatomic total shoulder replacement, or reverse replacement. Dr. Knudsen uses CT-based three-dimensional planning for every shoulder arthroplasty to customize implant selection, alignment, and fixation.
Patient Experience
“Dr. Knudsen vowed to stand by me from the beginning of my osteonecrosis diagnosis. Two surgeries later, I am pain-free and have more mobility than I had ever hoped for. I am humbly grateful for his persistence and great care.”
Patient treated for shoulder osteonecrosis | Google review
These testimonials describe individual patient experiences. Treatment recommendations, recovery, and outcomes vary by patient.
This information is educational and is not a substitute for an individualized medical evaluation. Written and medically reviewed by Michael L. Knudsen, MD | Last reviewed: July 2026
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