Ayurvedic Management of Avascular Necrosis Through Panchakarma and Oral Medication: A Case Report

Osteonecrosis is a degenerative bone condition characterised by the death of cellular components of the bone secondary to an interruption of the subchondral blood supply, also, known as Avascular Necrosis (AVN), it typically affects the epiphysis of long bones at weight-bearing joints. According to Ayurveda, AVN can be correlated with Asthimajjagata Vata. A 22-year-old female patient came to the Outpatient Department (OPD) with complaints of pain in bilateral hip joint, restricted and painful movement of the lower limbs and difficulty in walking. Her Magnetic Resonance Imaging (MRI) reports suggested AVN of Bilateral femoral head and neck, Grade 2 on right and Grade 3 on left (Ficat and Arlet classification) along with marrow oedema. The condition was addressed with a combination of various traditional ayurvedic medicines like Aarogyavardhini Vati, Maharasnadi Kwath, Punarnavadi Guggulu, Yograj Guggulu, Rasapachak Vati and Panchakarma like Sthanik Snehan (local oleation), Patra Pottali Swedana (fomentation), and Basti (medicated enema). Panchakarma was done for a period of 16 days and oral medication was continued for a period of three months. Significant relief in pain as per Visual Analogue Scale (VAS) reduced stiffness and increased range of motion was noted along with improvement in Harris Hip Score and Quality of Life (QoL) score. The current case underscores the effectiveness of Ayurvedic Panchakarma treatment in achieving positive outcomes for AVN.