AYURVEDIC APPROACH TO AVASCULAR NECROSIS - A CASE REPORT

Avascular necrosis (AVN) is the death of bone tissue resulting from an interrupted blood supply, progressing from an initial ischemic phase to a necrotic stage that frequently affects the femur, humerus, and knees, with 16000 new cases annually in India. While often asymptomatic in its early stages, it eventually leads to severe joint pain and bone collapse, particularly in men aged 30 to 50. Key risk factors include trauma, prolonged corticosteroid use, alcohol abuse, and underlying conditions like sickle cell anaemia or autoimmune diseases, with repetitive mechanical stress further accelerating joint degradation. The conventional treatments like oral medication, surgical intervention have limitations, Ayurveda offers a holistic approach. In Ayurveda, AVN is correlated with Asthimajjagata Vata, where the core pathogenesis involves the vitiation of Vata, Rakta, Asthi, and Majja and its treatment focuses on Vata Shamana, Raktashodhana and Dhatu Poshana. Case Report: A 52-year-old male with a history of T2 Diabetes Mellitus presented with a 15-year history of chronic, recurring pain primarily affecting the hip joints (Right > Left). The pain radiates to the right iliac region, bilateral thighs, and bilateral knees, accompanied by a pulling sensation in the right iliac and knee regions, and mild to moderate discomfort in the lower back and shoulders. Five years after the onset of symptoms, the condition progressed to an inability to bear weight on the right leg, a visible limp, and difficulty sitting for extended periods or sitting cross-legged. An MRI confirmed a diagnosis of Avascular Necrosis (AVN). While initial allopathic treatments provided partial relief, symptoms have persisted with episodic flare-ups, and the pain intensity has increased significantly over the last three years. Methodology: The treatment intervention is designed to address Vata, Rakta, Asthi Majja Dusti utilizing Manjishtadi Kshara Basti, Mustadi Yapana Basti and Matrabasti. Result: Post-treatment evaluation revealed significant result in reducing symptoms as determined by a comparative analysis of clinical signs and subjective symptoms. Conclusion – Panchakarma treatment modalities, specially Basti play important role in manage symptoms of AVN.