Hyperbaric Oxygen Therapy (HBOT) may support selected patients with early-stage AVN. At NUMA, treatment is individually assessed, medically prescribed and supervised alongside orthopaedic care.
Avascular necrosis, or osteonecrosis, develops when blood flow to bone is reduced or interrupted. It most often affects the femoral head and may progress to collapse, pain, loss of mobility and arthritis.
A 2025 meta-analysis of 10 studies (568 patients) found significant improvements after HBOT in pain, hip function and physical quality of life. A 2026 analysis of 29 studies (2,177 hips) found HBOT particularly favourable for pain and quality of life and also assessed imaging progression, with further research needed to establish its effect on structural disease progression.
A randomised double-blind trial found significant improvements in pain and range of motion following 30 HBOT sessions in patients with Stage II AVN.
In Stage I AVN, MRI findings normalised in 81% of HBOT-treated patients following a three-month treatment course, compared with 17% of untreated controls.
In Stage I–II AVN, 88% of joints showed MRI improvement after HBOT, with 93% of followed joints preserved at an average 11-year follow-up.
AVN is progressive, and treatment before femoral head collapse offers the best chance of preserving the joint. HBOT is an adjunct to standard orthopaedic care, not a replacement, with suitability assessed individually.
A clinical review of how HBOT may reduce bone hypoxia and marrow oedema, and what current evidence shows for pain, function, imaging and joint preservation.
Every plan begins with a medical questionnaire reviewed by Dr Nur, followed by a consultation where she prescribes a customised programme — determining the optimal duration, frequency, and total number of sessions.
Studies commonly use 30–40 sessions, five days a week, with each session lasting about 90 minutes at 2.0–2.5 ATA.
Once collapse or advanced arthritis has occurred, HBOT is unlikely to preserve the joint. It may still support recovery around surgery, while hip replacement may become the main treatment pathway.
Every treatment plan is personalised. The number, frequency and timing of HBOT sessions vary according to individual clinical circumstances and may change as treatment progresses.
HBOT is a medical treatment that requires specialist assessment and prescription to ensure it is safe, appropriate and tailored to your individual needs. Treatment is provided alongside, not in place of, your orthopaedic care. Your consultation with our specialist medical doctor includes:
Don't just take our word for it — hear directly from patients who have completed treatment with us.
A review of the evidence for HBOT in avascular necrosis, including bone marrow oedema and early, pre-collapse disease.
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How HBOT is used to support tissue repair, reduce oedema and aid recovery in athletes and active patients.
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A walk-through of a session at the clinic, from medical assessment and monitoring to time in the chamber.
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NUMA is a consultant-led specialist HBOT clinic focused exclusively on medical hyperbaric oxygen therapy. Our service combines medical oversight, personalised treatment planning and purpose-built facilities designed to support safe and high-standard care.
