International Journal of Health Sciences and Research Vol.12; Issue: 12; December 2022 Website: www.ijhsr.org Review Article ISSN: 2249-9571 International Journal of Health Sciences and Research (www.ijhsr.org) 204 Vol.12; Issue: 12; December 2022 Effect of Extracorporeal Shock Wave Therapy in Osteonecrosis of Femoral Head of Hip in Patients on Pain and Function: An Evidence Based Study Dr Ankita Patel 1 , Dr Asha Dabhi 2 , Dr Mukul Chauhan 3 , Dr Himanginiben Patel 4 1 Assistant Professor at SSCP College Bhandu, Mehsana, Gujarat, India 2 Assistant Professor at SSCP College Bhandu, Mehsana, Gujarat, India 3 Assistant Professor at SSCP College Bhandu, Mehsana, Gujarat, India 4 Student At Northumbria University, Newcastle Upon Tyne, England, United Kingdom Corresponding Author: Patel Ankita Vipul DOI: https://doi.org/10.52403/ijhsr.20221230 ABSTRACT OBJECTIVE: The aim of the study is to review the available literature on the use of Extracorporeal Shock Wave Therapy (ESWT) for the treatment of osteonecrosis of femoral hip (ONFH) to understand its therapeutic potential. MATERIALS AND METHODS: A systematic review was performed on the PubMed, Scopus, Science Direct, and Research Gate databases with the following inclusion criteria: Studies published in last 08 years. (2015 to 2022) Studies that includes subjects with AVN of HIP. RESULTS: 15 studies were reviewed from which 9 studies concluded that ESWT is effective in ONFH patients. CONCLUSIONS: Based on the analysis of these 9 articles, it can be concluded that ESWT is an effective treatment regimen in individual with ONFH patients. KEY WORDS: Extracorporeal Shock Wave Therapy (ESWT), Osteonecrosis of Femoral Head (ONFH), Pain, Hip Harris Score (HHS) INTRODUCTION Osteonecrosis of the femoral head (ONFH) was originally described in 1925 as an ischemic necrosis of the hip area [1] . It is also known as avascular necrosis, aseptic necrosis, and ischemic bone necrosis [2] . Its pathology is poorly understood; however, it is known to decrease blood flow to the femoral head leading to cellular death, fractures, and collapse of the articular surface [3,4] . ONFH is characterized by a compromised subchondral microcirculation, especially in the small retinacular vessels, which ultimately leads to necrosis of bone. An accumulation of microfractures is seen and, as there is no bone remodelling, a collapse of the subchondral bone occurs [5] . Based on our current information about AVN of the femoral head, increased intraosseous pressure developed following an ischemic attack in addition to enhanced edema in functionally constrained region of the bone marrow compartment creates a vicious cycle just like a compartment syndrome which compresses venules, and arterioles [6,7] . ONFH is a multifactorial disease with different etiologies ranging from genetic to idiopathic to certain risk factors such as trauma, hematological disorders, and steroid intake [8] . The clinical presentation is quite a specific and mainly concerns groin pain irradiating to the knee. There is some limited hip range of motion seen, especially in internal forced rotation. The alternative treatment are