Journal of Orthopaedic Diseases and Traumatology (Sep 2024)

Association between COVID-19 Infection and Avascular Necrosis of the Femoral Head: A Cross-sectional Observational Study

  • Anikrit Srivastava,
  • Gopal Pundkare,
  • Madhav Khadilkar,
  • Sanjay N. Patil

DOI
https://doi.org/10.4103/jodp.jodp_33_24
Journal volume & issue
Vol. 7, no. 1
pp. 99 – 102

Abstract

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Background: The COVID-19 pandemic, caused by SARS-CoV-2, has introduced numerous health complications beyond its primary respiratory effects. Notably, there is growing concern about its role in avascular necrosis (AVN) of the femoral head, a condition where disrupted blood supply leads to bone death. Factors such as hypercoagulability, extensive corticosteroid use, and potential direct vascular effects from the virus may contribute to this association. This article explores the link between COVID-19 and AVN, examining its mechanisms, prevalence, and clinical implications. MATERIALS AND METHODS: This cross-sectional, observational study enrolled 32 patients who had COVID-19 infection and subsequently developed AVN of the femoral head. Various factors influencing AVN development were considered, including the timing of COVID-19 infection during the pandemic’s first and second waves, steroid treatment duration, and alcohol consumption history. The diagnosis was made using X-ray and magnetic resonance imaging findings. Results: Out of 32 patients, 19 contracted COVID-19 during the first wave, while 13 were infected during the second wave, indicating a higher virulence rate during the first wave. Although 20 patients received short-term steroid therapy, the duration and the dosage were not significant for AVN development. Similarly, the duration and amount of alcohol consumption among 11 patients were not significant enough to cause AVN. Therefore, we feel that the pathogenesis of COVID-19 infection itself likely plays a key role in AVN development, with factors such as steroid use and alcohol consumption being incidental findings. Conclusions: According to this study, we feel that the pathogenesis of COVID-19 infection itself likely plays a key role in AVN development, with factors such as steroid use and alcohol consumption being incidental findings.

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