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You are correct. AVN has 4 stages - 1 and 2 are the early stages.
Stage 3 and 4 are the stages of arthritis - these last 2 stages are diagnosable on x rays. Stages 3 and 4 can be treated with resurfacing.
 

From my point of view as a resurfacing doc there is likely little to
be gained from an mri at this point. If you had a significant AVN it
would have shown up on the x-ray films your resurfacing surgeon saw
on your pre op appointment. If he viewed your films and felt a resurf
was possible don't worry. At worst he will find at the time of
surgery that your bone won't support a resurf and go with a MOM THR.

In my experience that can almost always be seen on plain x-ray so if
he didn't tell you about that you are likely a good resurf candidate.
Rather then speculate I would just contact your surgeon and ask.

As for knee pain that is common with hip arthritis but if it has
gotten worse a new hip x-ray can tell if your femoral head has
collapsed which might make a resurf harder. Many resurfs are done for
AVN with good results so don't worry about that.

Scott Rubinstein M.D.
Illinois Bone and Joint Institute.
 

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