Introduction

Avascular necrosis (AVN) also called as Osteonecrosis is a condition that occurs when there is loss of blood supply to the bone and bone tissues. As bone is a living tissue that requires continuous supply of blood, an interruption to it may lead to death of bone. If left untreated for a longer time, the bone becomes brittle, distorts and eventually breaks. In 90% cases, Avascular necrosis is in the hip joint but can sometimes be seen in humerus and knees too. Modern medicine treats only pain and in severe cases Total Hip Replacement surgery is done. After surgery also it takes a long time for recovery with limitation in movements and short life span of hip joint.

Case Presentation

A 43-years old male from Vellore having non-traumatic Stage-3 Avascular Necrosis, presented in December 2022 with complaints of severe pain in the left hip joint and lower back since 7 years . He was diagnosed to have non traumatic stage 3 AVN. The pain was insidious in onset and gradually progressive in nature with an intensity of 8-9/10 on VAS pain rating scale. He had difficulty in doing any activity like walking, standing or sitting, bending and had continuous dull pain in Left hip radiating till left knee. He was unable to squat and do criss-crossing of her legs and could not climb stairs. The pain reduces partially on taking rest and medications.

History of Past Medical Illness

The patient is Non-diabetic and non Hypertensive. No other comorbidities seen . No history of Alcoholism, smoking , Tobacco chewing. He was a driver by Profession. He consulted an Orthopaedic surgeon 4 years back who advised her to take out an X-Ray & MRI of hip joint along with other lab tests. According to Ficat and Arlet’s grading system, an X-ray showed stage-3 AVN of the left femoral head.

The Orthopaedic doctor advised a hip replacement surgery but patient was reluctant for the same and was started with a course of steroids and physiotherapy sessions to strengthen the core muscles. The patient showed minor pain reduction and some improvement in the daily activities. However, the pain progressed over 4 years to the extent to which the patient had difficulty in day-to-day activities like standing for 10 mins, sitting, unable to sit cross-legged, and bending. During the last 2 years due to covid
restrictions, she had to do all work by herself, which led to the pain getting aggravated to a scale of 9-10/10.

The aim of presenting this case is to see how Ayurveda and Siddha therapy worked on curing the Avascular Necrosis condition by reducing pain and improvement and better flexibility in hip joints. This was confirmed by noting her symptoms on VAS scale for pain and pre-post ROM (Range of Motion) assessment.

Conclusion

Siddha Vaidya, an ancient science that treats by aligning body energies (mind, body and spirit), to empower and activate the body’s internal healing mechanisms results not only in cure but also an improved quality of life. Siddha therapy along with diet and physiotherapy rehabilitation played a vital role in this case in reducing pain; enhancing muscle strength, functional independence, and quality of life in patients with stage 3 Avascular necrosis of the femur.