Management of Avascular Necrosis Through Panchakarma -a Case Study

Avascular necrosis of the femoral head (AVNF) is an increasingly common cause of musculoskeletal disability. It is a progressive pathological process, resulting in the death of bone cells of the femur head due to disruption of blood supply to the proximal femur. However, the healing process is usually effective in AVN, and the bone tissue breaks down faster than the body can repair. All the treatment procedures are cost worthy, and the prognosis is poor. Management of AVNF aims to prevent structural deformity, regulate functional activity, and relieve pain. There is no direct diagnostic correlation to AVNF in Ayurvedic classics; however, signs and symptoms of AVNF are nearer to Vatarakta and Asthimajjagata vata (disorders of musculoskeletal origin). Objectives: By considering AVNF as Vatarakta, Asthimajjagata vata has attempted in the present study to evaluate the efficiency of Ayurvedic formulation in the conservative management of AVNF. Method-A case of AVN with bilateral femoral head presented with complaints of pain in the bilateral hip region with difficulty in routine work, i.e. walking, sitting, squatting, along with a change in gait. Initially, the patient was treated with Manjishtadi Kshara Basti, followed by Manjishtadi Ksheera Basti and Anuvasana Basti with Panchatiktaka gritha as per Karma Basti schedule (modified), followed by Shaman Aushadhi. Result-Patient was observed for symptomatic improvement based on a questionnaire over graded signs & symptoms, also observed for clinical examination before & after treatment, and the therapy provided marked relief from pain, tenderness, stiffness and improvement in the gait & hip joint movements. Conclusion: The study has shown that conservative management of AVNF can be managed effectively through Ayurvedic principles and improve quality of life.