Abstract
Background: Avascular necrosis (AVN) or osteonecrosis is the death of bone tissues due to decreased blood flow of femoral head, it is a major orthopaedic disease with many risk factors including the chronic alcohol and tobacco consumption. 
 Aims and objectives: To study the relationship of alcohol and tobacco with AVN of femoral head in adult population.
 Materials and Methods: This study included 72 patients of AVN of femoral head (ONFH) who attending our hospital between Sept 2018 to Sept 2020. History of alcoholism and tobacco consumption, detailed information of the amount and duration of smoking and alcohol intake was recorded.
 Results: Majority of the AVN patients were working age groups males (72%) and 28% were females. Out of 72 patient 55% had history of alcohol consumption and 60% were smokers which indicates a positive correlation of cellular toxicity with AVN of femoral head.
 Conclusion: Present study conclude that the alcohol ingestion and tobacco smoking are the major cause of cellular toxicity and AVN of femoral heads.
 Keywords: alcohol drinking, femur head necrosis, smoking
Highlights
Osteonecrosis is a degenerative bone condition characterized by the death of cellular components of bone secondary to an interruption of the subchondral blood supply
There are numerous risk factors and theories on the development of this vascular impairment which can be classified in six categories as Extraosseous arterial fracture., Extraosseous venous, Intraosseous extravascular compression, Intraosseous intravascular occlusion and Direct cellular toxicity which includes the Chemotherapy, Radiotherapy, Thermal injury, Alcohol ingestion and Smoking. 2
Excessive alcohol consumption related to Avascular necrosis (AVN) of the femoral head (FH) is the result from the decreased bone genesis caused by excess lipid formation and increased intracellular lipid deposits which results in tissue death. 3
Summary
Osteonecrosis is a degenerative bone condition characterized by the death of cellular components of bone secondary to an interruption of the subchondral blood supply. It is known as avascular necrosis (AVN), aseptic necrosis, and ischemic bone necrosis. 2. Alcohol use has been associated with approximately 31% of patients who develop hip AVNFH. Excessive alcohol consumption related to AVN of the FH is the result from the decreased bone genesis caused by excess lipid formation and increased intracellular lipid deposits which results in tissue death. Smoking impaired the flow of oxygenated blood to bones and nicotine decreases bone healing strength as well as revascularization of bone grafts, which results in AVN of bones. This study attempts to reveal the relationship of alcohol and tobacco with AVN of femoral head in patients attending the Index Medical College, Indore, India
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