Medical Treatment: Avascular Necrosis (AVN) of Hip

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Dr Anurag Awasthi  Orthopaedic Specialist, Sohna Road, Gurgaon 9718112112

AVN Hip is defined as the irreversible changes in the femoral head, as a result of the interuption to the blood supply. It commonly follows fracture of femoral neck/ prolonged steroid intake/ alcoholism/ muco-polysaccharidoses/ sicle cell anemia etc.
The femoral head gradually undergoes changes in the density and architecture, ultimately leading to degenerative arthritis of hip joint.
In late stages, when arthritis has already set in, the only effective treatment is a total joint arthroplasty.
However, in the early pre-collapse stages, there is some role for a group of drugs known as Bisphosphonates.
Alendronate is a commonly used drug of this group. these drugs are available in both tablet and injection form; and dosing schedule varies from once daily to once a year.
Numerous studies have advocated that bisphosphonates, when used in early AVN hip (Ficat & Arlet stage I/II), results in improvement of symptoms and prevents radiological worsening in atleast 60-70 percent of patients. However, this drug needs to be taken for a period of 18-24 months to show appreciable improvement.
The prominent side effect associated with this drug is reflux oesophagitis.