<s>[INST] Hi doctor, I have pain in thighs, hip joints and legs for more than a year. Reports indicate avascular necrosis stage 3. Doctor has recommended me hip replacement. I am really scared of this. Because I did a lot of research on internet about this. I got to know a lot of restriction and risk of dislocation after surgery. What if I somehow avoid the surgery? Is there any chance of natural healing in long term of two to three years? [/INST] Hi. Thank you for using this platform. From the information you provided, it seems like you have stage 3 avascular necrosis (AVN). While there are numerous causes for AVN and often there is no identifiable cause, the prognosis is not very favorable once you reach stage 3. This stage is said to have been reached when the femoral head collapses and loses its round spherical shape. Due to the incongruency with the hip socket, there is undue friction during hip movements, and eventually the joint surfaces start getting eroded. Once this happens, it is said to be in stage 4 of osteoarthritis. It may be helpful if you could share your x-ray and MRI (magnetic resonance imaging) images with us. Also, has the cause of your AVN been diagnosed? How does the opposite hip look like? Often, the opposite hip may have early AVN and may be amenable to certain procedures to prevent it from reaching an irreversible state like your painful hip. I understand your worries with hip replacement. You are only 25 years old and any hip prosthesis has a limited life of its own with a high likelihood of needing a revision at some point. It may be best to postpone hip replacement for as many years as you can, so long as your hip pain does not prevent you from doing activities of daily living. For further information consult an orthopaedician and traumatologist online --> </s>