A REVIEW ON THE ROLE OF GUGGULU TIKTAKAM GHRITAM WITH GANDHA TAILAM SNEHAPANAM IN THE MANAGEMENT OF AVASCULAR NECROSIS (AVN) OF FEMUR HEAD

Abstract

Avascular necrosis of the femoral head is a type of osteonecrosis due to the disruption of blood supply to the proximal femur. The causes are either traumatic/ atraumatic in origin. It includes fractures, dislocation, use of chronic steroids, coagulopathies and rarely by infections including tuberculosis. The disruption of blood supply to the head of femur can lead to ischemia and subsequent necrosis. If restoration of blood supply does not occur promptly, it can lead to progressive death of osteocytes which inevitably leads to the collapse of the femoral head and subsequent limb shortening. Pain is restricted to weight-bearing activities initially but tends to progress eventually to pain at rest.  AVN is a progressive disorder with surgical management as the choicest intervention. It is clinically characterised by gradual onset of pain in the affected hip that may radiate down the affected limb. This condition can be effectively managed if it is diagnosed and treated early. Acharya Susruta explains 107 marmas in the purview of traumatology, injury to these vital points can lead to various effects from permanent deformity to death. The vitiated vata dosha clinically presents with bheda of asthi and parvas (piercing pain of bones and joints), sandhisoolam (pain of joints), satataruk (continuous pain), mamsabalakshaya (weakness of muscles) and asvapana (loss of sleep) all of which can be very well related to the symptoms of AVN. Ayurveda considers that the effective management of vata dosha is snehanam. Hence snehapanam with Guggulutiktakaghritam and Gandhathailam in the ratio 10:1 is taken up for the present trial. Guggulutiktakaghrita is mainly indicated in asthi, sandhi, majjagatavatavikaras. Gandha thailam is an exceptional restorative in fracture care and nutritional supplement in ligament injuries. Hence Snehapanam with Guggulutiktakaghritam and Gandhathailam is expected to bestow miraculous effects in the management of avascular necrosis.

KEYWORDS: AVN, Guggulutiktakam Ghritam, Gandha thailam.