What drugs can help in healing avascular necrosis?

Question

Hello doctor,

I am a 24-year-old male and I have pain in hip joints for more than three months. Reports indicate avascular necrosis stage 2. Pain is mostly in the right hip joint. Pain will appear only when I put extra stress on muscles. The doctor has recommended me core decompression and he cannot guarantee whether it will heal or not. I am really scared of this. What if I somehow avoid the surgery? Is there any chance of natural healing? I have attached photos for your reference.

Answer 1

Hello,

Welcome to icliniq.com.

I have gone through the attachments (attachment removed to protect patient identity). You have avascular necrosis of the femoral head. Most surgeons will ask you to get operated on for a core decompression or total hip replacement for this but studies have shown that medicines have a high possibility to avoid surgeries. You still are stage 2 with edema so there are good chances you will get better with medicines. I suggest the following (take the medications mentioned below after consulting a specialist and with their consent):

1. Take tablet Osteofos (Alendronic Acid) 35 mg twice a week for one year. This has to be taken empty stomach early morning with two glasses of water and do not lie down or eat for 30 minutes after taking the tablets.

2. Tablet Bio-D3 Strong (combination of Calcitriol, Calcium carbonate, manganese, Zinc, L-methyl folate, Methylcobalamin, and Vitamin K2-7) once a day for one year.

3. Tablet Uprise-D3 60K (Cholecalciferol) 60,000 International Units) once daily for 10 days then once a month for one year.

4. Tablet Flexon (Ibuprofen and Paracetamol) twice a day times 15 days after food then as needed with pain.

5. Tablet Rabeprazole 20 mg once a day times 15 days after food.

6. Injection of Zoledronic Acid 5 mg intravenous over 45 minutes once a year times three years.

7. Also, take two tablets of Crocin (Paracetamol) 500 mg five minutes before taking the injection and as needed after the injection (as you might get a mild fever with this injection).

Consult your specialist doctor, discuss with him or her, and with their consent take the above medicines. You should use a walking stick. You can walk but do not exercise or do physiotherapy. Follow up with X-rays and MRI (magnetic resonance imaging) images. This is only a second-opinion platform. This professional advice provided by me stands subject to the actual examination of the report or image and is based entirely on inputs provided to me. It should be correlated with clinical findings.