Alendronate in the treatment of avascular necrosis of the hip

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Abstract
Sir, Avascular necrosis (AVN) of the bone results from decreased blood supply to the bone, resulting in bone death. The most common site is the head of the femur. AVN is characterized by persistent, often nagging and disabling pain associated with significant reduction in joint movement and mobility. The condition tends to run a progressively downhill course. Medical and surgical management generally aims to improve the blood supply by vasodilators and antiplatelet drugs or by physically drilling holes and bone grafting to restore the blood supply to the avascular area. Eighty‐five per cent of patients with symptomatic AVN progress to end‐stage disease over a 2‐yr period [1]. So far, there is no universally accepted treatment that relieves pain and halts its progression. In this communication we report our early experience with the use of alendronate, a bisphosphonate, in AVN of the hip.

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