Iceberg to Orthopedics [ Avascular Necrosis Post Covid-19]

Abstract

Background: Avascular necrosis (AVN) has emerged as a concerning sequel of COVID-19 infection. Either the vasculitis associated with COVID-19 [1,2] or prolonged intravenous corticosteroid therapy administered during treatment [3,4] may contribute significantly to the development of AVN.

Material and Methods: A retrospective analysis was conducted at Shri Sathya Sai Medical College and Research Institute, where 33 patients were diagnosed with AVN between June 2022 and December 2022. Among them, 15 patients under the age of 40 had a prior history of COVID-19 (CORADS-4 and above), requiring hospital admission for 2–4 weeks and intravenous corticosteroid therapy [5,6]. These patients presented with hip pain, exacerbated by sitting and exertion, and were diagnosed with Stages I–III AVN.

Results: The study suggests a potential link between COVID-19 and AVN, with notable vasculitis changes observed in affected patients [7,8]. This highlights the need for further research with larger study groups to establish clinical significance and potential preventive strategies [9].

Conclusion: The occurrence of AVN in post-COVID-19 patients underscores the importance of vigilant follow-up and early intervention in those at risk [10]. Physicians should consider AVN as a differential diagnosis in patients presenting with persistent hip pain post-COVID-19 [11]. Further studies with larger cohorts are necessary to delineate the pathophysiology and establish robust preventive and therapeutic measures [12].