Ayurvedic Management of Asthi Majjagata Vata w.s.r. to Avascular Necrosis (AVN): A Case Series

Abstract

Asthi Majjagata Vata, a Vata-predominant Vyadhi described in the Brihattrayi, correlates clinically with Avascular Necrosis (AVN) of the femoral head, a progressively disabling condition affecting a largely young and active population. Since Basti is regarded as Ardhachikitsa for Vata Vyadhi, a Basti-predominant Panchakarma protocol was evaluated as a supportive, non-surgical approach for improving pain, mobility and hip function in early-stage disease. The objective of this study was to study the clinical presentation of Asthi Majjagata Vata correlated with AVN of the femoral head/hip joint and to evaluate the efficacy of a standardised Panchakarma-based Basti protocol using VAS, SLRT, LFM/LEM and Harris Hip Score (HHS) as outcome measures. This prospective, single-arm, observational case series included ten consecutively presenting patients (age 18–60 years) with clinico-radiologically confirmed Grade I–II AVN of the hip/femoral head. The patients were managed with a staged protocol of Sarvanga Snehana-Swedana, an initial Shodhana Yoga Basti (Niruha Dashamoola-Erandamoola/Anuvasana Sahachara Taila) followed by Mustadi Yapana Basti for 14 days, with individualised adjunct procedures. Outcome measures were recorded before and after treatment. Across all ten cases, Mean VAS scores decreased from 7.3 to 4.6, indicating a mean reduction of 2.7 points. SLRT measurements generally improved, although some patients retained pain or limitation. LFM/LEM improved in seven patients. Mean HHS increased from 62.1 to 81.04, demonstrating a mean gain of 17.94 points. The Basti predominant Panchakarma protocol was associated with improved pain and hip function in this case series. These preliminary findings warrant controlled studies with standardised radiological staging and longer follow-up.