Dr.Santpure’s Regime for AVN

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Hip Preservation and Treatment Protocols by Dr. Shivkumar Santpure

Dr. Shivkumar Santpure provides advanced treatment protocols for different stages of bone collapse, combining medication, injections and surgical options to ensure effective and personalised orthopaedic care."

Stage II – Pre-Collapse (H2):

Medical Management and Joint Preservation

Injections:

Inj. Teriparatide SC daily × 3 months

Inj. Denosumab SC (1 dose)

Inj. Vitamin D 6L IM (1 dose)

Inj. Metadec 25 IM (1 dose)

Tablets:

Methotrexate 7.5 mg weekly

Leflunomide 10 mg OD

Ecosprin 75 OD

Calcium 500 mg OD

For Pain (short term):

Aceclofenac 200 + Rabeprazole 20 OD × 10 days

SOS for pain

Vitamin Support:

SOS for pain

Bone Strengthening:

Idrofos 150 (Ibandronate) monthly at 7 AM with water × 6 months

Additional Surgical Option (H2):

Percutaneous Multiple Drilling

Performed under C-arm (not core decompression).

Usually combined with opposite side Total Hip Replacement (Stage 3/4).

Complimentary (free of cost) if combined with THR.

Core decompression offered only if patient opts for cultured osteoblasts (Ossgrow by Regrow).

Stage III – Early Collapse (H2):

Continue with Stage II regimen.

Wait and watch approach.

If symptoms worsen → Total Hip Replacement (THR).

Stage IV – Late Collapse & Arthritis (H2):

Uncemented Total Hip Replacement (THR) recommended.

Ceramic-on-Ceramic (CoC) bearing for younger patients.

Ceramic-on-Poly (CoP) bearing for patients above 50 years.