by NR INDRAN / INT

Dr Sanjay Agarwala, Chief of Surgery,Head Orthopaedics & Traumatology, Hinduja Hospital who has always had the distinction of being listed in various “Who’s who including the prestigious “Marquis Who’s Who in the World” from 1998 onwards, has now created another new world record. Dr Sanjay Agarwala’s treatment for Avascular Necrosis Of Hips is a boon for millions of people around the world. His ten years of successful research has resulted in this prestigious and significant achievement for patient care, gleaming India proud.

Dr Sanjay Agarwala’s path breaking discovery and treatment for Avascular Necrosis (AVN) of Hips has been not only been talk of the town but also is finding its way into the textbooks. ANV of the bone is an extremely painful and progressively disabling disorder. AVN when left untreated leads to hip arthritis, needing surgical intervention like surface replacement or total hip replacement, making a patient suffer besides shelling out a dear sum in the process of ‘fixing’ AVN. Discovery of this cost effective and efficient treatment method has been published in medical journals including the recent coverage in The Journal of Arthroplasty, prompting the international medical fraternity to consider adapting to the same.

Dr Sanjay Agarwala has created history of sort by establishing a new hope for all those patients who have painful joints stricken by AVN. Dr Agarwala for the last 10 years has successfully used the key drugs Alendronate, a Bisphosphonate, in over 400 patients to treat AVN of the hip, thus relieving them from the pain and perhaps avoiding the need for a surgery. Hip is a joint that connects your upper part of the body to the legs and if damaged then the person becomes completely immobile. The drug Alendronate prevents bone resorption and is most commonly and normally used to treat osteoporosis.

Dr Sanjay Agarwala, Chief of Surgery, Head Orthopaedics&Traumatology, Hinduja Hospital, Mumbai said “Avascular Necrosis of the bone is a painful, progressively disabling disorder. The hip (femoral head) is the most common site. Avascular Necrosis (AVN) of the femoral head is a pathologic process that results from the interruption of blood supply to the bone. Untreated, it progresses to frank hip arthritis needing surgical intervention which is total hip replacement or surface replacement arthroplasty.”

Dr Sanjay Agarwalafurther said “The good news for Indian patients is that the cost of this treatment works out to approximately Rs 150 per month and considering that it prevents an expensive one lakh rupee surgery and the pain, this is a panacea in the management of these cases.”

Recently Mr. Jignesh Shah, a businessman from Mumbai was suffering from AVN and has been successfully treated using this novel method. Mr. Shah is completely relieved and is leading a perfectly normal life devoid of pain, without undergoing any surgery.

Mr Jignesh Shah said “I am thankful to Dr. Agarwala and his research that has saved my life, which has made me normal and mobile without undergoing any surgical intervention. This treatment is a saviour for millions of people across the world”.

There are others like Jignesh Shah who are undergoing the same treatment and as expected they are responding quite well to Dr. Agarwala’s treatment. The AVN remedial treatmenthas been done on over 400 patients effectively; hence this research has found its mention in various international medical journals.

Dr Sanjay Agarwala’s thought for the future and that he is already currently working on would be Ethics Committee approved gene therapy and regeneration and Regrowth of diseased bones.

Avascular necrosis (AVN), also called osteonecrosis, aseptic necrosis, or ischemic bone necrosis, is a condition that occurs when there is loss of blood to the bone. Because bone is living tissue that requires blood, an interruption to the blood supply causes bone to die. If not stopped, this process eventually causes the bone to collapse.

Avascular necrosis most commonly occurs in the upper leg. Other common sites are the upper arm, knees, shoulder, and ankles.

Who Gets Avascular Necrosis and What Causes It?

As many as 20,000 people develop AVN each year. Most are between the ages of 20 and 50. For healthy people, the risk of AVN is small. Most cases are the result of an underlying health problem or injury. Possible causes include:

Dislocation or fracture of the thigh bone (femur). This type of injury can affect the blood supply to the bone, leading to trauma-related avascular necrosis. AVN may develop in 20% or more of people who dislocate a hip.

Chronic corticosteroid use. Long-term use of these inflammation-fighting drugs, either orally or intravenously, is associated with 35% of all cases of nontraumatic AVN. Although the reason for this is not completely understood, doctors suspect these drugs may interfere with the body’s ability to break down fatty substances. These substances collect in the blood vessels — making them narrower — and reduce the amount of blood to the bone.

Excessive alcohol use. Much like corticosteroids, excessive alcohol may cause fatty substances to build in the blood vessels and decrease the blood supply to the bones.

Blood clots, inflammation, and damage to the arteries. All of these can block blood flow to the bones.

Other conditions associated with nontraumatic AVN include:

• Gaucher’s disease, an inherited metabolic disorder in which harmful quantities of a fatty substance accumulate in the organs.

• Sickle cell disease.

• Pancreatitis, inflammation of the pancreas.

• HIV infection.

• Radiation therapy or chemotherapy.

• Decompression sickness, a condition that occurs when the body is subjected to a sudden reduction in surrounding pressure, causing the formation of gas bubbles in the blood.

Symptoms of Avascular Necrosis

In its early stages, AVN typically cause no symptoms; however, as the disease progresses it becomes painful. At first you may experience pain when you put pressure on the affected bone. Then, pain may become more constant. If the disease progresses and the bone and surrounding joint collapse, you may experience severe pain that interferes with your ability to use your joint. The time between the first symptoms and collapse of the bone may range from several months to more than a year.

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