Efficacy of core decompression with bisphosphonates and Prolotherapy compared with core decompression alone and core decompression with bisphosphonates in the management of avascular necrosis of hip joint

Abstract

Background: Avascular necrosis (AVN) of hip joint or femoral head is complex disease with complete collapse of the femoral head. Core decompression is the mainstay treatment for grade I and II AVN of hip joint but the results were controversial. In this backdrop, the present study was undertaken to evaluate the combination of core decompression with bisphosphonates and prolotherapy in the treatment of AVN of hip joint. Methods: 36 patients who were diagnosed with for grade I and II AVN of hip joint were recruited and they were divided into three groups (n=12). The patients in three groups were treated with core decompression alone, core decompression with bisphosphonates and core decompression with bisphosphonates, prolotherapy. The patients were followed at 6th month, after 1 year and 2 years respectively. Their outcomes and range of motion were recorded at each follow-up.Results: The outcome of the study shows that the combined treatment of core decompression with bisphosphonates, prolotherapy showed fair outcome at the end of 2 year follow up with effective pain reduction during walking, squatting and cross leg. Meanwhile, core decompression alone and core decompression with bisphosphonates showed poor and good outcome. Conclusion: Thus in patients with grade I and II AVN of hip joint combination of core decompression with bisphosphonates, prolotherapy would be effective in prevention of collapse and pain reduction.