Abstract

INTEGRATED AYURVEDIC MANAGEMENT OF AVASCULAR NECROSIS OF THE FEMORAL HEAD (ASTHIMAJJAGATA VATA): A CASE REPORT

Ayushi Chandil*, Vivek Sharma, Rajesh Meshram

Abstract

Avascular necrosis (AVN), also known as osteonecrosis, is a progressive degenerative disorder caused by interruption of blood supply to bone tissue, leading to cellular death, structural collapse, and functional disability. The femoral head is the most commonly affected site. Contemporary management strategies primarily include conservative symptomatic treatment in early stages and surgical interventions such as core decompression or total hip replacement in advanced stages. However, long-term outcomes are variable, and surgical procedures carry considerable morbidity, particularly in younger individuals. In Ayurveda, AVN can be correlated with Asthimajjagata Vata, a condition characterized by vitiation of Vata dosha affecting Asthi and Majja dhatu. Materials and Methods: A 35-year-old male patient presented with bilateral hip pain radiating to the lower limbs, stiffness, and difficulty in walking. MRI revealed bilateral avascular necrosis of the femoral head (Stage II on the right side and Stage III on the left side). The patient was treated with Patrapinda Swedana, Sthanik Basti, and Dashmoolasiddha Majja Basti for 21 days along with oral Kaishora Guggulu (500 mg twice daily) and Dashamoola Kwatha (40 ml twice daily).Clinical parameters including pain, stiffness, range of motion, and gait were assessed before and after treatment. Results: The patient showed moderate to significant improvement in pain intensity, reduction in stiffness, improvement in gait pattern, and enhanced functional capacity. No adverse effects were observed during the treatment period. Conclusion: This case suggests that a combined Panchakarma and Shamana therapy approach may provide symptomatic relief and functional improvement in early to mid-stage avascular necrosis of the femoral head. Further controlled clinical studies are required to validate these findings.

Keywords: Avascular necrosis, Osteonecrosis, Asthimajjagata Vata, Majja Basti, Dashamoola, Ayurveda.