A ten-year follow-up of 40 patients at PD Hinduja Hospital, Mahim, has found that medication can help most patients suffering from avascular necrosis of the hips (where the blood flow to the hip bone stops) avoid a hip replacement surgery.
It has thus been established that medication can be an alternative for undergoing a hip replacement surgery, said Dr Sanjay Agarwala, consultant orthopaedic surgeon, Hinduja Hospital.
The ten-year follow-up study concluded that after 40 patients underwent a treatment for three years, 87% of the hips (some patients had avascular necrosis in both hips) survived. The remaining patients had to undergo a hip replacement surgery.
Dr Agarwala first used the biphosphate drug, earlier used only to cure osteoporosis, for avascular necrosis treatment in 1998.
“Medical management can prevent collapse of the aging bone by conserving it. In a period of three years, which is the life span of the disease, nature takes over allowing the blood vessels to start forming inside the bone,” said Dr Agarwala.
Jignesh Shah, 43, was diagnosed with avascular necrosis of the left hip in 2006 and was unable to walk. Shah started taking the medication in 2006 and continued it for three years. “I now climb up 3800 steps to go to Palithana temple in Gujarat every year,” said Shah.
Dr Agarwala stumbled upon the treatment while treating an avascular necrosis patient who refused to undergo surgery. “I first gave him the drugs on the principle that it is used to treat osteoporosis. In three weeks, the patient told me that his pain had reduced substantially. I had never had the same result with a surgery,” said Dr Agarwala.
The drug is most effective in avascular necrosis patients who are diagnosed early.
“In a nutshell, the drug given for three years maintains its beneficial effects for as long as 10 years by changing the natural history of avascular necrosis of the hips,” stated the study.