This treatment is being suggested   on bases of the information provided.  However I would like to examine & investigate you  in detail. -Control  Hypertension, Diabetes or  metabolic disorder, if there is any.  -Any way it may be tried, --. Dolokind Plus (Mankind) [Aceclofenac100 mg +Paracetamol 350 mg] 1 tab. OD & SOS. X 5 days. --. Caldikind plus  (Mankind) 1 tab OD x 10 days. -(You may need help of your local doctor to get these medicines.) --. Fomentation with warm water. Let the part not be exposed to cold. --. Sleep on a hard bed with soft bedding. --. Keep a pillow under the knees. --. Avoid painful acts & activities. -- .Do mild exercises for back and lower limbs. --.(Take help of physiotherapist or you can visit my you tube channel 'Dr NC Gupta'.)   & see  'me and my yoga'; & 'yoga simplified'. Kindly subscribe to the channel to get notifications for further new information of your interest.  --Do not ignore, let it not become beginning of a major problem. --Do ask for a detailed treatment plan. Kindly make sure, there is no allergy to any of these medicines. --For emergency treatment visit nearest hospital. --Wish you a quick recovery & good health. --I hope, I have solved your problem to your satisfaction.   Dr N C Gupta MS (ortho) DMC 3624  

Best is replacement surgery Other options are..  vascular muscle pedicel graft

Yes he needs Total hip replacements on the right hip at it's already stage 3.  This mri indicates there are some changes at acetabulum also. So we only have THR as an option. You haven't post ur x-ray to see the acetabulum.  Also it's advisable to go for core decompression on grade 1 avn of hip, but his left Hip has grade 2 avn, still it's good to do core decompression to delay the progression of avn and to promote healing, along with some form of vascular or non vascular bone graft.

Given your age sir , THR is the best option if you are active.

If your Head in MRI is spherical then there is a slight chance that hip can be saved with medicine and if pain is a lot or Head of hip bone collapsed then chances of improvement with medicines are less Also send if you have any Diabetes, hypertension, thyroid, bronchial asthama or any history of covid

Always treat the Patient not MRI is the thumb rule. Depends on patient condition and symptoms. if someone doesnot want THR then core decompression can be attempted with bone marrow infiltration. rest is recommended Safe surgical decompression is also a very good method to do Hip preservation