The treatment of Avascular Necrosis (AVN) of the hip joint through advanced, non-surgical injections has emerged as an effective approach to relieve pain, enhance joint function, and slow down or halt disease progression. Dr. Neeraj Kumar Goyal has pioneered a multi-step injection regimen designed to target pain, support bone healing, and improve joint health for AVN patients across all stages—from Grade I to Grade IV. His protocol incorporates Growth Factor Concentrate (GFC) injections, Prolotherapy, and Pain Portal Blocks with Ozone Therapy. This comprehensive treatment approach not only provides pain relief from the very first session but also aims to restore the blood supply, reduce inflammation, and stimulate tissue regeneration.

AVN of the hip joint occurs when blood flow to the femoral head is reduced or interrupted, causing bone cells to deteriorate and eventually die. As a result, the affected bone begins to weaken and collapse, leading to severe pain, joint stiffness, and eventually loss of hip function. Without intervention, AVN progresses and may require invasive treatments like hip replacement surgery. However, Dr. Goyal’s non-surgical approach has provided an effective alternative for managing and potentially reversing the condition’s progression.

Understanding Avascular Necrosis of the Hip Joint and Treatment Challenges

The severity of AVN is classified into four grades:

• Grade I: Early stages with minimal symptoms and slight blood flow issues.
• Grade II: Noticeable pain, stiffness, and structural weakening of the bone.
• Grade III: Increased bone collapse, joint deformity, and limited mobility.
• Grade IV: Advanced joint damage with complete collapse and severe pain.

While medications and physical therapy may temporarily relieve symptoms, they often fail to restore blood supply or repair damaged bone tissue. In severe cases, surgery is often recommended. However, Dr. Goyal’s approach using GFC, Prolotherapy, and Pain Portal Blocks with Ozone offers an effective, non-surgical alternative for pain management and potential healing across all AVN grades.

Treatment Components and Mechanisms

Dr. Goyal’s approach incorporates three main components that are carefully scheduled: GFC injections, Prolotherapy, and Pain Portal Blocks with Ozone Therapy. Each treatment modality targets different aspects of AVN, allowing for a comprehensive and synergistic effect that maximizes patient outcomes.

1. Growth Factor Concentrate (GFC) Injections – Once a Month

Growth Factor Concentrate (GFC) injections are a specialized form of regenerative therapy that utilizes concentrated growth factors, which are naturally occurring proteins in the body that stimulate tissue repair. These growth factors are extracted from the patient’s own blood, processed to concentrate them, and then injected into the affected hip joint. By delivering growth factors directly to the site of damage, GFC injections improve blood flow, reduce inflammation, and stimulate the regeneration of bone and soft tissues.

How GFC Injections Help in Treating AVN:

• Promoting Angiogenesis: Growth factors encourage new blood vessel formation, which restores blood flow to the femoral head, a critical step in reversing the effects of AVN.

• Bone Regeneration: GFC stimulates the production of new bone cells, helping to rebuild and strengthen the weakened bone tissue in the hip joint.

• Pain and Inflammation Reduction: Growth factors have natural anti-inflammatory properties, which help reduce pain and discomfort in the joint.

For patients in the early stages (Grade I and II) of AVN, GFC injections are particularly effective in preventing further progression of the condition. However, patients with more advanced AVN (Grade III and IV) also benefit significantly from pain relief, increased stability, and improved joint function due to the regenerative effects of GFC injections.

2. Prolotherapy – Administered Once a Month (15 Days After GFC)

Prolotherapy, or proliferative therapy, involves injecting an irritant solution, typically containing dextrose, into the affected hip joint and surrounding ligaments. This injection triggers a mild inflammatory response that stimulates the body’s healing processes, promoting the production of new collagen and strengthening connective tissues around the hip joint. For AVN patients, Prolotherapy helps stabilize the joint, reduce pain, and enhance the effects of GFC injections.

Key Benefits of Prolotherapy for AVN Patients:

• Joint Stability: By strengthening ligaments and other supporting structures, Prolotherapy improves joint stability, reducing stress on the affected bone.

• Induction of Natural Healing: The mild inflammation induced by Prolotherapy attracts healing cells to the area, supporting tissue regeneration in the hip joint.

• Pain Relief: As Prolotherapy strengthens joint stability, patients experience less pain and improved range of motion.

When alternated with GFC injections, Prolotherapy maximizes the healing potential of the treatment by working alongside GFC to improve joint integrity and function. This combination is especially valuable for patients in Grades II through IV, where joint stability is crucial in managing pain and preventing further collapse.

3. Pain Portal Blocks with Ozone Therapy

Pain Portal Blocks with Ozone Therapy combine the benefits of targeted nerve blocks with the therapeutic properties of ozone gas, which has been shown to promote healing and reduce inflammation. Pain Portal Blocks involve injecting an anesthetic and ozone mixture into the specific areas within the hip joint that are causing pain. This treatment provides immediate pain relief, reduces inflammation, and supports the body’s regenerative processes over time.

How Pain Portal Blocks with Ozone Aid in AVN Treatment:

• Immediate Pain Relief: Patients experience near-instantaneous pain relief, allowing them to move more comfortably and engage in rehabilitation exercises.

• Anti-Inflammatory Effects: Ozone has strong anti-inflammatory properties that reduce swelling and alleviate pain over time.

• Enhanced Oxygenation: Ozone therapy improves oxygen levels in tissues, supporting cell regeneration and joint health, which are particularly beneficial for AVN patients with compromised blood supply.

• Cartilage and Bone Preservation: By reducing oxidative stress, ozone helps protect the remaining cartilage and bone structures in the hip joint, slowing down the degenerative process.

This component of the treatment regimen is especially helpful in relieving pain for patients with advanced AVN (Grades III and IV), allowing them to manage symptoms effectively and maintain a higher quality of life.

Treatment Schedule and Regimen: 30-Day Rotational Approach

Dr. Goyal’s treatment protocol alternates between GFC injections, Prolotherapy, and Pain Portal Blocks with Ozone on a 30-day rotational cycle. This schedule ensures that each treatment has sufficient time to work while supporting the effects of the other components.

Monthly Treatment Schedule Example:

1. Day 1: GFC Injection – Introduces growth factors for bone regeneration and blood flow improvement.
2. Day 15: Prolotherapy Injection – Stabilizes the hip joint, stimulates healing response, and strengthens connective tissues.
3. Pain Portal Blocks & Ozone injections along with GFC and Prolotherapy are given – Provides immediate pain relief and anti-inflammatory support.

By following this rotational approach, the treatment allows each modality to complement and reinforce the others, leading to steady progress over time.

Expected Outcomes and Long-Term Benefits

Patients generally experience significant pain relief from the first Pain Portal Block session, which allows them to regain mobility and participate more fully in physical activities and rehabilitation exercises. Over the first few months, patients also notice improvements in joint function, reduced stiffness, and better overall stability. The cumulative effects of the rotational GFC, Prolotherapy, and Ozone therapy schedule allow for sustained pain relief and gradual tissue regeneration.

Long-Term Benefits of Dr. Goyal’s AVN Treatment Approach:

• Immediate Pain Reduction: From day one, patients report relief from hip joint pain, allowing them to resume daily activities and maintain mobility.

• Increased Joint Stability and Function: By strengthening surrounding tissues and promoting bone regeneration, the treatment improves the joint’s ability to bear weight and function effectively.

• Delayed or Avoided Surgery: For many patients, this comprehensive treatment approach delays or prevents the need for hip replacement surgery, especially beneficial for younger individuals with early-stage AVN.

• Better Quality of Life: With pain relief and improved joint stability, patients can lead active, pain-free lives without dependence on strong painkillers or invasive surgeries.

Ideal Candidates for This Treatment

Dr. Goyal’s non-surgical approach is suitable for patients across all AVN stages, from Grade I to Grade IV. In early stages, it helps prevent further progression, while in later stages, it focuses on pain relief and functional preservation.

• Grade I and II Patients: For those in the early stages, this approach can slow down or halt disease progression by regenerating blood flow and stabilizing the joint.

• Grade III and IV Patients: For advanced stages, this protocol offers an alternative to surgery, managing pain and maintaining mobility by strengthening the joint and reducing inflammation.

Patient Success Stories and Testimonials

Dr. Goyal’s innovative, patient-centered approach has transformed the lives of many individuals suffering from AVN of the hip joint. Many patients have shared testimonials on how this treatment regimen has allowed them to lead pain-free, active lives and avoid the complexities of surgery.

Why Choose Dr. Neeraj Kumar Goyal’s AVN Management Approach?

1. Non-Surgical and Minimally Invasive: This treatment avoids the risks of surgery by providing a natural, minimally invasive solution for pain management and joint regeneration.

2. Extensive Experience: Dr. Goyal’s expertise, gained from 19 years in orthopedic care, ensures that each patient receives high-quality care and effective treatment outcomes.

3. Personalized, Comprehensive Care: Dr. Goyal tailors each treatment plan based on the patient’s specific condition and goals, ensuring maximum benefit from the treatment.

4. Cutting-Edge Techniques and Facilities: Equipped with state-of-the