MANAGEMENT OF AVASCULAR NECROSIS OF FEMORAL HEAD IN SICKLE CELL ANAEMIA BY MAJJA BASTI – A CASE STUDY.

Introduction:Avascular necrosis is also known as aseptic, osteonecrosis and ischaemic necrosis of bone. There are a multitude of risk factors but over 80% of cases are attributed to glucocorticoid treatment or alcohol excess. Avascular Necrosis of femoral head is the most common type of necrosis, because the artery supplying to neck of femur is very narrow which easily gets injured. In modern medicine there is no specic treatment rather than surgery. In Ayurveda avascular necrosis can be correlated with Asthimajjagatvata. Aim: To assess the efcacy of Dashmooladi Majja Sneha in the management of avascular necrosis. The objective of the treatment includes the preservation of structure and function of hip joint with symptomatic relief. Materials & Methods:The present case study is upon a 32 year old, diagnosed case of avascular necrosis of femoral head with complaints of pain in bilateral sacroiliac joint since one and half years which was associated with difculty in doing normal daily activities such as walking, sitting, squatting along with change in the gait, at the Panchakarma OPD of Govt. Ayurvedic hospital Bhopal. The patient of idiopathic AVN of femoral head was treated with Dashmooladi Majja Sneha, Brihatvata Chintamani Rasa, Amritaristha, Panchtikta Ghrita Guggulu and Shastik Shali Pind Swedan have done as per the classical method for 30 days. Assessment was done after treatment and follow up after 15 days for 2months. Observations: The Ayurvedic therapies and oral medicines yielded complete symptomatic relief from pain, general debility and improvement in the gait. Conclusion: On the basis of the results obtained it can be concluded that Dashmooladi Majja Sneha, Shastik Shali Pind Swedan and some oral medicines can be used as an effective treatment in the management of Avascular Necrosis.

Download Full-text

Risk factors and impact of orthopaedic monitoring on the outcome of avascular necrosis of the femoral head in adults with sickle cell disease: 215 patients case study with control group

Orthopaedics & Traumatology Surgery & Research ◽

10.1016/j.otsr.2011.09.011 ◽

2011 ◽

Vol 97 (8) ◽

pp. 814-820 ◽

Cited By ~ 12

Author(s):

M. Mukisi-Mukaza ◽

C. Saint Martin ◽

M. Etienne-Julan ◽

M. Donkerwolcke ◽

M.E. Burny ◽

...

Keyword(s):

Risk Factors ◽

Femoral Head ◽

Sickle Cell Disease ◽

Avascular Necrosis ◽

Sickle Cell ◽

Control Group ◽

Cell Disease

Download Full-text

Stem Cell Therapy for Avascular Necrosis of Femoral Head in Sickle Cell Disease: Report of 11 Cases and Review of Literature

International Journal of Stem Cells ◽

10.15283/ijsc17019 ◽

2017 ◽

Vol 10 (2) ◽

pp. 179-183 ◽

Cited By ~ 5

Author(s):

Mir Sadat-Ali ◽

Md Q Azam ◽

Ezzat M Elshabouri ◽

Ahmad M Tantawy ◽

Sadananda Acharya

Keyword(s):

Stem Cell ◽

Femoral Head ◽

Sickle Cell Disease ◽

Cell Therapy ◽

Avascular Necrosis ◽

Sickle Cell ◽

Stem Cell Therapy ◽

Review Of Literature ◽

Cell Disease ◽

Necrosis Of Femoral Head

Download Full-text

The Clinical and Radiological Effectiveness of Autologous Bone Marrow Derived Osteoblasts in the Management of Avascular Necrosis of Femoral Head in Sickle Cell Disease.

10.21203/rs.3.rs-179614/v1 ◽

2021 ◽

Author(s):

Mir Sadat-Ali ◽

Abdallah S Al-Omran ◽

Sadananda Acharya ◽

Tarek M Hijazi ◽

Abid H Gullenpet

Keyword(s):

Bone Marrow ◽

Femoral Head ◽

Sickle Cell Disease ◽

Avascular Necrosis ◽

Sickle Cell ◽

Joint Arthroplasty ◽

Long Term Results ◽

Cell Disease ◽

Necrosis Of Femoral Head

Abstract Background and Objective: Avascular necrosis of femoral head is a common Issue faced by orthopaedic surgeons which ranges between 10-18% but in sickle cell Disease the incidence reaches 30%. There is no definite treatment except joint arthroplasty. Regenerative medicine is an option to cure or delay joint arthroplasty. We report here our experience with injection of ABMDO to manage ANFH and report our long term results,progression of the ANFH if any and delay in THA (Total Hip Arthoplasty).Patients and Methods: Sixty-Three (63) consecutive patients with SCD with ANFH were examined, thoroughly investigated and those who had ANFH < grade II were consented to receive ABMDO. Pre-operatively patients were clinically assessed using Visual analogue scale (VAS), Modified Harris Hips Score (MHHS) and Azam-Sadat Score (ASS) for Quality of Life Score for Chronic Hip Disease. Ten milliliter of bone marrow was aspirated under local anesthesia and was placed in 20 CC culture media. Osteoblasts were cultured from the bone marrow aspirated. Under anesthesia using 3 mm cannulated drill, the osteonecrosed lesion was drilled and 5 million osteoblasts were injected at the lesion site. Patients were evaluated in out patient clinic after two weeks. At four months a repeat MRI was done and patients were followed up a minimum for 2 years.Results: The average age was 25.93±5.48 years. There were 41 (65%) females and 22 (35%) males. The mean hemoglobin S was 83.2±5.1 percent. The average follow up was 49.05±12.9 ( range 24-60) months. VAS significantly improved from 7.79±1.06 at 2 weeks 4.07±1.08 p<0.0001 continued to improve for the next 24 months 2.38±0.55 (P<0.0001). MHHS improved from 41.77±5.37 to 73.19± 6.48 at 4 months (P<0.001) and at 24 months it was 88.93±3.6 (p<0.001). The ASS also significantly improved from 2.76±0.49 preoperatively to 7.92±0.09 (p<0.0001) at 24 months. A comparison of the MRI’s of before and after osteoblast implantation revealed new bone formation and amelioration of the avascular lesions. Three patients were unhappy with the outcome and one patients repeated attacks of the vaso-occlusive crisis within six months of the osteoblasts injection.Conclusions: The results give credence to our earlier short follow up results that osteoblasts transplantation has a great potential in healing of avascular lesions. Our study fits the criteria of Phase II clinical trial and We believe a larger study equivalent to Phase III numbers and include patients not only with sickle cell disease but also steroid induced and idiopathic avascular necrosis.

Download Full-text