Integrated Ayurvedic Management of Avascular Necrosis of the Femoral Head (Gambhira Vatarakta) Through Jalukavasecana Followed by Kalavasti

Abstract

Avascular Necrosis (AVN) of the femoral head is a type of osteonecrosis resulting from impaired blood supply to the proximal femur, leading to bone necrosis and joint dysfunction. Trauma, chronic steroid intake, and excessive alcohol consumption are the major etiological factors. The condition manifests with pain, stiffness, and restricted movement of the hip joint. In Ayurveda, AVN can be correlated with Gambhira Vatarakta, where aggravated Vata and Rakta cause degeneration of Asthi and Sandhi Dhatus. Panchakarma therapies, particularly Jalukavasecana and Vasti, are indicated for purifying vitiated Rakta and pacifying Vata. Objective: To evaluate the efficacy of Jalukavasecana followed by Kalavasti with Yashtyahvadi Niruha and Bala-Guducyadi Taila Anuvasana Vasti in the management of Avascular Necrosis of the femoral head (Gambhira Vatarakta). Methodology: This is a pre and post-interventional study. The intervention included Jalukavasecana performed in three sittings over a period of seven days, followed by Kalavasti administered using Yashtyahvadi Niruha Vasti and Bala-Guḍucyadi Taila Anuvasana Vasti. Clinical outcomes were assessed using the Numeric Pain Rating Scale (NPRS), Harris Hip Score (HHS), and Range of Motion (ROM) before treatment, after treatment, and at one-month follow-up. Results: Post-intervention, there was a marked reduction in pain and stiffness with improvement in functional ability and range of motion. NPRS and HHS showed significant improvement, which was maintained at one-month follow-up. Conclusion: This case highlights the scope and potential of Pañchakarma therapies in the conservative management of early stages of Avascular Necrosis of the femoral head (Gambhira Vatarakta).