Avascular Necrosis - Market Share Analysis, Industry Trends & Statistics, Growth Forecasts (2026-2031)

The avascular necrosis market size is expected to grow from USD 644.23 million in 2025 to USD 701.56 million in 2026 and is forecast to reach USD 946.53 million by 2031 at 6.17% CAGR over 2026-2031. This report is Segmented by Treatment Type (Drugs, Bone Replacement Devices & Implants), Disease Type (Traumatic, Non-Traumatic Avascular Necrosis, and More), Diagnosis (Imaging, Biopsy, and More), End User (Hospitals, Specialty Clinics, and More), and Geography (North America, Europe, Asia-Pacific, Middle East & Africa, South America). The Market Forecasts are Provided in Terms of Value (USD).

Global Avascular Necrosis Market Trends and Insights

Rising Incidence of Steroid-Induced and Trauma-Related Bone Ischemia

Corticosteroid exposure remains the strongest modifiable demand driver in the avascular necrosis market. A 2024 review in Diagnostics reported incidence ranging from 3% to 37% in patients receiving high-dose corticosteroids, and it noted a 21% rate even in high-dose users without added risk factors. A 2025 review in the Journal of Orthopaedic Research linked post-COVID AVN onset to a mean latency of 126 days and cumulative steroid exposure of 1,198 mg prednisolone equivalent. This pattern matters because many of these patients are in the 30-45 age group, which increases demand for joint preservation instead of immediate replacement. Trauma-related AVN is also supporting the avascular necrosis market, because fractures, dislocations, and crush injuries still create a durable surgical pool in high-volume orthopedic systems. The combined effect is a wider treatment funnel that supports drugs, decompression, implants, and regenerative care across the avascular necrosis market.

Expanding Joint-Replacement and Bone-Preservation Procedure Volumes

Procedure expansion remains one of the clearest growth supports for the avascular necrosis market. The American Joint Replacement Registry recorded more than 4.4 million hip and knee arthroplasty procedures through 2024, and its 2025 annual report showed an 8.8% year-over-year increase in procedure count. That trend confirms that late-stage intervention demand remains elevated, even after pandemic-related disruption has passed. The avascular necrosis market benefits directly because total hip arthroplasty still absorbs a large share of advanced femoral head collapse cases. Bone-preserving surgeries also remain relevant in earlier disease, especially when patients are diagnosed before structural collapse. Wider approval for same-day arthroplasty and continued device launches should keep procedure volume growth central to the avascular necrosis market over the forecast period.

High Procedure Costs and Reimbursement Friction

Reimbursement remains one of the clearest brakes on the avascular necrosis market. Aetna updated coverage policy CPB 0753 in November 2025 and tightened the distinction between covered core decompression use and experimental adjunctive cell-based procedures billed under newer CPT codes. That keeps many regenerative approaches outside routine reimbursement, even as clinical evidence becomes stronger. The avascular necrosis market, therefore shows a mismatch between medical promise and commercial access. In China, price compression in hip implants has also reduced conventional device margins, after reported prices moved from CNY 35,000 (USD 4,900) to CNY 7,000 (USD 980) under national procurement pressure. This pushes manufacturers toward premium systems and leaves parts of the avascular necrosis market exposed to pricing pressure even when unit demand is rising.

Other drivers and restraints analyzed in the detailed report include:

• Rising Adoption of Early MRI-Based Diagnosis and Risk-Stratified Screening
• Growing Pipeline for Regenerative and Cell-Based Joint-Preservation Therapies
• Late Presentation and Low Primary-Care Recognition

Segment Analysis

Bone replacement devices and implants held 53.83% share in 2025, and this category is also projected to grow at the fastest 7.15% CAGR through 2031. This leadership shows how much of the avascular necrosis market still depends on late-stage surgical intervention after structural collapse has occurred. Total hip arthroplasty, revision procedures, and cementless fixation systems remain the main revenue base in this segment. The category also benefits from surgeon familiarity, strong registry support, and a steady launch cycle in robotic and navigation-linked platforms. That has kept the avascular necrosis market anchored to devices even as earlier-stage treatment pathways expand.

The Australian registry evidence cited in the source draft points to strong commercial traction for cementless systems, with Stryker's Trident acetabular shell identified as the most implanted cementless acetabular system in that registry. This matters because bone ingrowth fixation is well aligned with the needs of many AVN patients who progress to total hip arthroplasty. Bone grafts and vascularized graft techniques remain relevant, but their uptake depends more heavily on specialist skill and center capability. Drugs still play a durable supporting role in the avascular necrosis market by addressing pain, inflammation, and vascular risk factors in earlier disease stages. A 2026 Scientific Reports study also linked pravastatin plus fibrin sealant-embedded bone marrow stem cells with better repair outcomes and stronger VEGF expression in a steroid-induced model, which suggests that drug and biologic boundaries may keep narrowing. That crossover could gradually broaden the treatment mix inside the avascular necrosis market without displacing the central role of implants in advanced disease.

Non-traumatic AVN accounted for 60.38% of the avascular necrosis market share in 2025, and it is also the fastest-growing disease segment with a 6.76% CAGR through 2031. This pattern places steroid exposure, systemic disease, and vascular compromise at the center of the avascular necrosis market. The segment is especially important because it often creates multifocal disease and repeated imaging, treatment, and follow-up needs across several joints. A 2025 report cited in the source draft described rising multifocal osteonecrosis in corticosteroid-treated patients, which lifts the average burden per case. That dynamic gives the avascular necrosis market a broader service and product requirement than a single-joint procedural model would suggest.

Steroid-induced disease remains the largest subtype within non-traumatic AVN, while idiopathic and radiation-related cases add smaller but harder-to-predict patient pools. Sickle cell disease-associated and lupus-related presentations also shape demand in selected regions where those underlying disorders are more visible in clinical practice. Traumatic AVN still represents a large secondary pool, near 40% of the segment in the source draft, and it often reaches care through fracture, dislocation, and post-surgical pathways. A 2026 network meta-analysis in Frontiers in Endocrinology found that high-dose autologous stem cell therapy combined with core decompression lowered the risk of hip failure and femoral head collapse relative to decompression alone. That finding is commercially relevant because traumatic cases can be well-suited to hip-preserving strategies when they are identified early enough. Together, these patterns keep the avascular necrosis market focused on both complex systemic disease management and surgically defined injury-related care.

Complete Report Scope:

• By Treatment Type
  • Drugs
    • Nonsteroidal Anti-Inflammatory Drugs
    • Cholesterol-Lowering Drugs
    • Blood Thinners
    • Other Drugs
  • Bone Replacement Devices and Implants
    • Bone Grafts
    • Joint Replacement Surgery
    • Cementless Prosthesis
• By Disease Type
  • Traumatic Avascular Necrosis
  • Fracture-Induced
  • Dislocation-Induced
  • Post-Surgical
  • Crush Injury-Related
  • Sports Injury-Associated
  • Non-Traumatic Avascular Necrosis
  • Steroid-Induced
  • Alcohol-Induced
  • Sickle Cell Disease-Associated
  • Lupus-Related
  • Radiation Therapy-Induced
  • Idiopathic
• By Diagnosis
  • Imaging
  • Biopsy
  • Computed Tomography Scan
  • Positron Emission Tomography
  • X-Ray
• By End User
  • Hospitals
  • Specialty Clinics
  • Rehabilitation Centers
  • Ambulatory Surgical Centers
  • Home Care Settings
• By Geography
  • North America
    • United States
    • Canada
    • Mexico
  • Europe
    • Germany
    • United Kingdom
    • France
    • Italy
    • Spain
    • Rest of Europe
  • Asia-Pacific
    • China
    • Japan
    • India
    • Australia
    • South Korea
    • Rest of Asia-Pacific
  • Middle East & Africa
    • GCC
    • South Africa
    • Rest of Middle East & Africa
  • South America
    • Brazil
    • Argentina
    • Rest of South America

Geography Analysis

North America held 38.63% of the avascular necrosis market share in 2025, which kept it as the largest regional contributor. The United States drives this position through broad implant availability, dense MRI capacity, mature orthopedic referral networks, and reimbursement support for major joint replacement procedures. The 2025 American Joint Replacement Registry report documented more than 4.4 million cumulative hip and knee arthroplasty procedures through 2024, which reflects the depth of the regional procedural base. This infrastructure gives the avascular necrosis market a strong platform for both advanced-stage surgery and earlier imaging-led intervention. Canada and Mexico add to regional volume, with Canada offering stable public coverage and Mexico supporting cross-border orthopedic care in selected centers.

Europe remains a stable part of the avascular necrosis market because large health systems in Germany, France, and the United Kingdom support access to imaging, surgery, and follow-up care. Aging populations in Italy and Spain also keep disease management demand active. Western Europe is moving faster in robotic hip arthroplasty and AI-enabled guidance, which strengthens the premium device layer of the avascular necrosis market. The European Medicines Agency framework for advanced therapy medicinal products will remain important for cell-based commercialization across the region. Eastern European markets remain more cost sensitive, which favors generic drug use and mid-tier implant adoption.

Asia-Pacific is the fastest-growing region in the avascular necrosis market, with a projected 7.04% CAGR through 2031. China dominates the regional opportunity, and the source draft cited more than 8 million cumulative non-traumatic femoral head necrosis cases with 150,000 to 200,000 new diagnoses each year. China also shows how procurement pressure can expand procedure access while reducing conventional implant pricing, which is pushing suppliers toward premium robot-compatible systems. Japan is advancing novel implant technology, and Zimmer Biomet received PMDA approval in September 2025 for an iodine-treated total hip system that directly matters for infection-conscious orthopedic care. South Korea supports a smaller but premium regenerative segment, while Middle East and Africa and South America remain earlier-stage opportunities because of reimbursement gaps, workforce shortages, and lower MRI penetration outside major cities.

List of Companies Covered in this Report:

• Athersys, Inc.
• Aurobindo Pharma Ltd.
• Bayer
• Bone Therapeutics
• Dr. Reddy’s Laboratories
• Exactech
• Integra LifeSciences
• Johnson & Johnson
• Medtronic
• Merck
• Mesoblast Limited
• Novartis
• Pfizer
• Regrow Biosciences Pvt. Ltd.
• Sanofi
• Smiths Group
• Stryker
• Teva Pharmaceutical Industries
• Vericel
• Zimmer Biomet

Additional Benefits:

• The market estimate (ME) sheet in Excel format
• 3 months of analyst support