Corticosteroids induced avascular necrosis of hip, a “long COVID-19” complication: Case report

Annam, Prathiba; Manda, Anusha; Myneni, Uday Krishna; Sahar, Aaminah Najmus; Prasad, Nagendra; Sam, Kezia K.; Sahu, Sambit; Reddy, Kiran Kumar

doi:10.1016/j.amsu.2022.104753

Cited by 11 publications

(13 citation statements)

References 9 publications

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“…of patients (no. of hips) Age (years)* Gender Comorbidity Follow up** M F 1 Agarwala et al [ 19 ] India 2021 Case report 3 (5 hips) 37.3 ± 1.3 (36–39) 3 0 NR 70.7 days (30–84) 2 Sulewski et al [ 15 ] Poland & Switzerland 2021 Case series 3 (3 hip)‡ 66.7 ± 3.4 (62–70) 1 2 1 DM 7.3 months (5–10) 3 Yilmam et al [ 29 ] Turkey 2021 Case report 1 (2 hips) 44 0 1 Congenital Torticollis NR 4 Agarwala et al [ 18 ] India 2022 Case series 48 patients (88 hips) NR NR NR NR 10 months (6–13) 5 Annam et al [ 20 ] India 2022 Case report 2 (4 h...…”

Section: Resultsmentioning

confidence: 99%

“…Thirty-five (19.2%) hips were surgically managed, 16 (8.8%) were treated by core decompression [ 20 , 24 , 25 , 27 , 28 , 30 ]; a concomitant bone graft or bone marrow aspirate was injected in four [ 27 , 30 ], and a concomitant medical treatment was accompanied in two [ 27 ]. First stage THA (debridement and application of antibiotic-loaded cement spacer) was performed in three (1.6%) hips [ 21 ].…”

Section: Resultsmentioning

confidence: 99%

“…First stage THA (debridement and application of antibiotic-loaded cement spacer) was performed in three (1.6%) hips [ 21 ]. Primary THA was performed in 13 (7.1%) hips [ 15 , 20 , 22 , 25 , 26 ], and staged THA was performed in five (2.7%) hips [ 21 , 23 ]. Four hips were later converted to THA after initial core decompression in one [ 28 ], and initial medical treatment in three [ 22 ].…”

Section: Resultsmentioning

confidence: 99%

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Femoral head avascular necrosis in COVID-19 survivors: a systematic review

Hassan

Khalifa

2023

Rheumatol Int

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The current systematic review aimed to document published cases of femoral head avascular necrosis (FHAVN) post-COVID-19, to report the COVID-19 disease characteristics and management patients received, and to evaluate how the FHAVN were diagnosed and treated among various reports. A systematic literature review was performed per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines through a comprehensive English literature search on January 2023 through four databases (Embase, PubMed, Cochrane Library, and Scopus), including studies reporting on FHAVN post-COVID-19. Fourteen articles were included, ten (71.4%) were case reports, and four (28.6%) case series reported on 104 patients having a mean age of 42.2 ± 11.7 (14:74) years, in which 182 hip joints were affected. In 13 reports, corticosteroids were used during the COVID-19 management plan for a mean of 24.8 ± 11 (7:42) days, with a mean prednisolone equivalent dose of 1238.5 ± 492.8 (100:3520) mg. A mean of 142.1 ± 107.6 (7:459) days passed between COVID-19 diagnosis and FHAVN detection, and most of the hips were stage II (70.1%), and concomitant septic arthritis was present in eight (4.4%) hips. Most hips (147, 80.8%) were treated non-surgically, of which 143 (78.6%) hips received medical treatment, while 35 (19.2%) hips were surgically managed, 16 (8.8%) core decompression, 13 (7.1%) primary THA, five (2.7%) staged THA and three (1.6%) had first stage THA (debridement and application of antibiotic-loaded cement spacer). The outcomes were acceptable as regards hip function and pain relief. Femoral head avascular necrosis post-COVID-19 infection is a real concern, primarily attributed to corticosteroid usage, besides other factors. Early suspicion and detection are mandatory, as conservative management lines are effective during early stages with acceptable outcomes. However, surgical intervention was required for progressive collapse or patients presented in the late stage.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Femoral head avascular necrosis in COVID-19 survivors: a systematic review

Hassan

Khalifa

2023

Rheumatol Int

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“…34 After the COVID-19 pandemic, there are some case reports and case series of AVN related to COVID-19. [11][12][13][14][15][16][17][18][19][20][21] In COVID-19 patients, multiple mechanisms, such as endothelial dysfunction, clot formation, and corticosteroid consumption, may occur simultaneously, which all lead to bone infarct or osteonecrosis. The prevalence of AVN related to COVID-19 was reported to be around 0.07%.…”

Section: F I G U R Ementioning

confidence: 99%

“…It seems that in COVID‐19 patients, multiple mechanisms, such as endothelial dysfunction, clot formation, and corticosteroid consumption, may occur simultaneously, which all lead to bone infarct or osteonecrosis. There are some case reports of AVN related to COVID‐19 around the world 11–21 . Data have shown that AVN in COVID‐19 develops in shorter time compared with this pathology in patients without COVID‐19 22 .…”

Section: Introductionmentioning

confidence: 99%

Who is the convict; COVID‐19 or corticosteroid? Late onset avascular necrosis of hips after COVID‐19. A case report with literature review

et al. 2023

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AimAvascular necrosis (AVN) or osteonecrosis is characterized by death of bone tissue due to endothelial damage and vascular abnormality. Coronavirus can induce endothelial damage and abnormal blood clotting, so that COVID‐19 is known as a vascular disease. We aim to evaluate the relationship between AVN and COVID‐19.CaseHere we present a 39‐year old man with severe COVID‐19 and corticosteroid consumption who developed late onset AVN of both hips 20 month after COVID‐19.ConclusionAn awareness of the possible osteonecrosis for all physicians dealing with patients with musculoskeletal problems following COVID‐19 is necessary.

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A Peek into the Life of an Asthmatic

Tresa Paul

2024

Research Partners With Lived Experience

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Corticosteroids induced avascular necrosis of hip, a “long COVID-19” complication: Case report

Cited by 11 publications

References 9 publications

Femoral head avascular necrosis in COVID-19 survivors: a systematic review

Femoral head avascular necrosis in COVID-19 survivors: a systematic review

Who is the convict; COVID‐19 or corticosteroid? Late onset avascular necrosis of hips after COVID‐19. A case report with literature review

A Peek into the Life of an Asthmatic

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