Total joint replacement surgery remains the last choice for patients with avascular necrosis. Total joint replacement surgery is done only when there is significant arthritis and the sphericity of the head of the femur is lost because of lack of blood supply.
Today it is not acceptable for younger patients to remain in pain, and disabled, and have no mobility because of the pain from avascular necrosis. I have done several surgeries in younger patients because there was no choice for them apart from suffering in pain and being on pain medications.