AVASCULAR NECROSIS

Avascular necrosis (AVN) of bone is a painful, progressively disabling disorder, more commonly affecting hip joints. Untreated, it progresses to hip arthritis needing surgical intervention (Total hip replacement). Various Surgical treatment exists for the management of AVN of the hip, including core decompression (with or without grafting or stem cells). None of these treatments have been shown to have consistent and good results and many patients ultimately require Total Hip Replacement Surgery.

Dr Mayank Vijayvargiya offers a medical management for the treatment of this painful, debilitating condition of AVN. He has conducted extensive research in this field and has 6 peer-reviewed published articles in national and international journals establishing the efficacy of bisphosphonates in avoiding the need for surgery for AVN. This treatment was established by his mentor Dr Sanjay Agarwala in a ground-breaking discovery in 2001.

The team has been using Bisphosphonate to treat AVN of the hip for the last twenty years with great success. Most of the patients who came to us for AVN have been advised for surgical treatment. But, in 80% of these, surgical intervention was avoided with our treatment. Those that needed surgery had advanced disease with arthritis. This requires the management of the joint arthritis and may need hip replacement.

In our published article of 20 years use of bisphosphonates in the management of AVN in JBJS (OA), the team has shown that the bisphosphonate therapy can halt disease progression, prevent collapse the need for surgery. These studies have shown 95% success rate in Stage I, 91% success rate in stage II and 70% in stage III, which is far better than various studies done in the past, which had a success rate of only around 30%.

Our team was the first in the world to write about the occurrence of AVN in patients recovered from COVID-19. We have reported that patients who had COVID 19 infections are more susceptible to AVN development at lower dose of steroids and earlier onset of symptoms. However, with early diagnosis, they can be treated successfully with our medical treatment of bisphosphonates.