People who are suffering from Avascular Necrosis (AVN) of hips, have been suggested surgery as the only option of treatment, and are apprehensive of undergoing a surgery, need not lose hope. Now, this painful condition can be tackled using medication. According to the findings of Dr. Sanjay Agarwala, Chief of Surgery, Head, Orthopaedics and Traumatology, Hinduja Hospital, the use of Alendronate, a bisphosphonate in the treatment of AVN has relieved patients from pain and helped avoid surgery.
AVN, which is also called osteonecrosis, aseptic necrosis or ischemic bone necrosis, is a condition which occurs due to loss of blood supply to the bone. Due to this lack of blood supply to the bone, the bone dies and eventually collapses. AVN, if untreated, progresses to arthritis, which requires surgeries like total hip replacement or surface replacement arthroplasty.
Till date, surgery was considered to be the only option for people suffering from AVN, but now it has been proved that medication too can help better this condition. The ethics committee has also approved this treatment option. The discovery of this treatment method has been published in medical journals including the ‘The Journal of Arthroplasty’.
Speaking about the treatment Dr. Agarwala said, “Destruction and subsequent layering of the bones is the mechanism followed by our body. But, in cases where destruction takes place and the layering becomes slow, the medicine layers down on the bone and arrest its destruction. It conserves the bone while the blood vessels are naturally formed. This is a slow process. Alendronate is most commonly used in the treatment of osteoporosis.”
The course of this medicine is three years because the life span of this condition is the same. The medication aids nature to take over the growth of blood vessels. “There is no reversal of necrosis, but there is preservation of the bone. Alendronate is most effective for hips because AVN is most commonly seen in hips but it also works well for shoulders, knees and other bones. The disease can recur but one can take a call after the course is complete,” said Dr. Agarwala.
Alendronate can be taken in form of tablets or even through IV and the cost of this mode of treatment is Rs.150 per month, making it affordable for the common man. Speaking about the dosage, Dr. Agarwala said, “Bisphosphonate is difficult to absorb in the blood, so giving a small quantity everyday is better. The methodology is also very important here. Also, there is difficulty in absorption if it is taken after food. So it is advised that the medicine is taken on an empty stomach with two glasses of water.”
‘A miracle pill’
Jignesh Shah (43) a diamond merchant from Andheri who had symptoms of AVN since 2006, calls this tablet a miracle pill. “I was having severe pain in the left side and I consulted eight doctors in the city. All of them suggested surgery to me. Later, when I was referred to Hinduja Hospital and started taking medication, I started feeling much better. Today after completing the three-year course, I have no trouble at all,” said Jignesh.
Symptoms of AVN
In its early stages, AVN has no symptoms, but as the disease progresses it becomes painful. At first, you may experience pain when you put pressure on the affected bone. Then, pain may become more constant. If the disease progresses and the bone and surrounding joints collapse, you may experience severe pain that interferes with your ability to use your joint. The time between the first symptoms and collapse of the bone may range from several months to more than a year. The affected age bracket is 20 and 50.