Proportion of Avascular Necrosis of Femoral Head in Coronavirus Disease 19 Patients

Objectives: Clarify the distinctive characteristics of avascular necrosis of the femoral head (AVNFH) in relation to coronavirus disease 19 (COVID-19) and report the successive individuals who were identified with the condition after recovering from COVID-19. Materials and Methods: From August 2023 to July 2024, we examined 24 successive patients (35 hips) prospectively who received an AVNFH diagnosis after recovering from COVID-19. Twenty patients were on corticosteroids for the treatment of COVID-19. The staging of AVNFH was decided by plain radiographs and magnetic resonance imaging. An association between the stage with the dosage of steroids and the comorbidities was evaluated. Results: After COVID-19, hip symptoms took a mean of 6.13 months to manifest. In Methylprednisolone equivalent, the average steroid dosage was 713.2 mg. For those on steroid medication, the mean time for COVID-19 before hip complaints was 5.95 months. It was discovered that the mean COVID-19 period before the onset of hip symptoms was 7.125 months for individuals without comorbidities and 3 months for those with both diabetes and hypertension. Conclusion: There has been an increase in AVN during the pandemic. This rise is probably because patients with COVID-19 pneumonia were receiving severe doses of corticosteroids. There is also an increase in severity and decrease in the duration of COVID-19 before hip symptoms in patients with comorbidities like diabetes. Given the minimal total amount of steroids taken by our patients, it is possible that vasculitis-associated COVID-19 contributes to the pathophysiology of AVN of the femur head.