Management of Avascular Necrosis through Ayurveda - A Case Study

Background: Avascular necrosis (Avn) of head of the femur is one of the growing condition seen in musculoskeletal clinics. It is basically an osteonecrosis caused due to an injury or any occlusion in the blood vessels nourishing the bone tissue. AVN of femur head is the most common type of necrosis because the artery supplying to that area is very narrow which easily gets injured followed by mere dislocation or a sub capital fracture which leads to lack of nourishment resulting in necrosis. In modern medicine no any specific treatment rather than surgery is available. Moreover it is expensive and has poor prognosis too. According to the principles of Ayurveda Vata, Pitta, Rakta Dosha play major role in the pathogenesis of AVN along with involvement of Asthi and Majja Kshaya (depletion of bony tissue). Aim: To assess the efficacy of Panchatikta Kshira Basti (enema prepared out from Tikta Dravya like Nimba (Azadirachta indica), Patola (Trichosanthes dioica), Vyagri (Solanum surattence), Guduchi (Tinospora cordifolia), Vasa (Adhatoda vasica) in the management of avascular necrosis. The objective of the treatment includes the preservation of structure and function with relief of pain. Materials & Methods: The present case study is upon a 23 year old, diagnosed case of avascular necrosis of femoral head with complaints of pain in bilateral hip region since one and half years which was associated with difficulty in doing normal daily activities such as walking, sitting, squatting along with change in the gate, at the Panchakarma OPD of All India Institute of Ayurveda New Delhi.. The patient of idiopathic AVN of femoral head was treated with Dashmooladi Niruha Basti along with Panchatikta Guggulu Ghritam and Yastimadhu Taila Siddha Anuvasana Basti. Kaal Basti (a variety of enema) was done as per the classical method for 16 days. Assessment was done after Basti and after 15 days of follow up. Observations: The therapies yielded complete symptomatic relief from pain, tenderness, general debility and improvement in the gait. Conclusion: On the basis of the results obtained it can be concluded that Panchatikta Kshira Basti can be used as effective treatment in the management of Avascular Necrosis.