Ayurvedic management of Asthimajja gata vatarakta (Avascular necrosis of head of the femur) – A case report

Avascular necrosis is a condition where the bone tissue starts degenerating due to interrupted blood supply to the bone tissue. It is also known as ischemic bone necrosis, aseptic necrosis or osteonecrosis. From the contemporary medicine the management of AVN goes by pain management and joint replacement surgery. There is no direct correlation for AVN in Ayurveda. But concepts like Asthi kshaya, Asthi majja gata vata, Asthi majja gata Vatarakta symptoms stands very close to this disease condition. A female patient of age 42 came to the OPD complaining of pain in the bilateral hip joints with difficulty in walking since 6 months. MRI of the hip reveled grade 2 AVN of bilateral femur head. Patient was diagnosed as a case of Asthi majja gata Vatarakta with physical examinations. Pancha tikta ksheera kashaya, Lakshaguggulu, was given. Sandhaneeya mahakashaya gana Ksheera basti (enema with medicines processed in milk) was given to the patient for 14 days after sthanika snehana ans swedan . Pancha tikta ksheera kashaya has tikta and kashaya rasa. Tikta rasa has ashraya asharee bhava with asthi dhatu. Hence it improves the quality of asthi dhatu. Laksha guggulu helps in reducing the pain and improving the quality of rakta (rakta). Medicines included in Sandhaneeya mahakashaya gana are either Tikta, Kashya , Madhura. These rasa helps in reducing the rakta dushti (impaired circulation) and improves microcirculation. Ksheera basti helps in improving the quality of Asthi and majja dhatu. It also helps in reducing the pain in the affected region.