Avascular necrosis of femoral head following COVID-19 infection

Saywan K Assad; Mohammed Sabah; Fahmi H Kakamad; Abdulwahid M Salih; Rawezh Q Salih; Shvan H Mohammed; Razhan K Ali; Berun A Abdalla; Marwan N Hassan

doi:10.1097/MS9.0000000000001098

Avascular necrosis of femoral head following COVID-19 infection

Ann Med Surg (Lond). 2023 Jul 25;85(9):4206-4210. doi: 10.1097/MS9.0000000000001098. eCollection 2023 Sep.

Authors

Saywan K Assad^{1

2}, Mohammed Sabah², Fahmi H Kakamad^{1

2

3}, Abdulwahid M Salih^{1

2}, Rawezh Q Salih^{2

3}, Shvan H Mohammed³, Razhan K Ali⁴, Berun A Abdalla^{2

3}, Marwan N Hassan^{2

3}

Affiliations

¹ College of Medicine, University of Sulaimani.
² Smart Health Tower.
³ Kscien Organization, Azadi Mall.
⁴ Shar Hospital, Department of Surgery, Sulaimani, Kurdistan, Iraq.

Abstract

Introduction: It is crucial to be aware of post-COVID-19 non-pulmonary complications. Avascular necrosis (AVN) is one of these complications. It should be noted that the risk of AVN persists in individuals who have recovered from the COVID-19 infection. The current study aims to report several cases of AVN after being infected with SARS-CoV-2.

Materials and methods: This is a single-centre retrospective case series conducted over a 2-year period (January 2021-December 2022) involving individuals who developed AVN after being infected with COVID-19.

Result: The study included a total of 17 patients. The mean age of patients was 38.65±6.1 years. Twelve of them were male (70.6%) and five were female (29.4%), with a ratio of 3:1. The mean BMI of the patients was 28.3±2.4 kg/m². Eleven (64.7%) patients reported administering steroid injections throughout the infection course. The mean interval between COVID-19 infection and presentation to the clinic was 6.53 months. The majority of patients (82.3%) complained of bilateral hip pain. Limping was observed in 47% of the cases. MRI showed AVN in all cases. Bilateral core decompression was performed in five cases (29.4%), total hip replacement in three cases (17.6%), and conservative treatment in nine cases (53%).

Conclusion: The ongoing pandemic may have many long-term sequelae. There is a risk of developing AVN after COVID-19.

Keywords: Avascular necrosis; Osteonecrosis; Post-COVID-19 syndrome; SARS-CoV-2; post-COVID-19 complications.