2024, Number 1
<< Back Next >>
Acta Ortop Mex 2024; 38 (1)
Avascular necrosis of the hip secondary to long-standing COVID
García-Dobarganes-Barlow F, Valadez-Soto J, Saavedra-Islas N, García-Romo V, Mata-Coronado J, Villavicencio-Ocampo E, Encalada-Díaz M
Language: Spanish
References: 14
Page: 48-51
PDF size: 171.56 Kb.
ABSTRACT
Long COVID is a term used to describe the long-terms effects of COVID-19 infection that continue for weeks or months after the patient has recovered from COVID-19. Long COVID is defined by the persistence of symptoms beyond 12 weeks from the onset of the disease. Corticosteroids are part of the treatment in this period with good results in controlling the disease; however, it is a predisposing factor for the development of avascular necrosis. We present a clinic case of a young man of 39 years old with diagnosis of avascular necrosis in his left hip, before the administration of corticosteroids for the treatment of COVID-19. There is a lack of consensus about the dosage and duration of steroids required to develop avascular necrosis. Some authors have reported that cumulative dose of 2,000 mg prednisone (or its equivalent) was required for avascular necrosis development. For patients with advanced avascular necrosis stages total hip arthroplasty is an attractive option with excellent outcomes in terms of pain relief and survivorship.
REFERENCES
WHO coronavirus disease (COVID-19) dashboard. Available in: https://data.who.int/dashboards/covid19/cases?n=c
Mahase E. Covid-19: what do we know about "long covid"? BMJ. 2020; 370: m2815. doi: 10.1136/bmj.m2815.
Leung TYM, Chan AYL, Chan EW, Chan VKY, Chui CSL, Cowling BJ, et al. Short- and potential long-term adverse health outcomes of COVID-19: a rapid review. Emerg Microbes Infect. 2020; 9(1): 2190-9. doi: 10.1080/22221751.2020.1825914.
Powell C, Chang C, Naguwa SM, Cheema G, Gershwin ME. Steroid induced osteonecrosis: an analysis of steroid dosing risk. Autoimmun Rev. 2010; 9(11): 721-43. doi: 10.1016/j.autrev.2010.06.007.
Agarwala S, Shah S, Joshi VR. The use of alendronate in the treatment of avascular necrosis of the femoral head: follow-up to eight years. J Bone Joint Surg Br. 2009; 91(8): 1013-8. doi: 10.1302/0301-620X.91B8.21518.
Cohen-Rosenblum A, Cui Q. Osteonecrosis of the femoral head. Orthop Clin North Am. 2019; 50(2): 139-49. doi: 10.1016/j.ocl.2018.10.001.
Chan KL, Mok CC. Glucocorticoid-induced avascular bone necrosis: diagnosis and management. Open Orthop J. 2012; 6: 449-57. doi: 10.2174/1874325001206010449.
Jones JP. Osteonecrosis. In: Koopman WJ, ed. Arthritis and allied conditions: a textbook of rheumatology. 14th ed. Philadelphia, Pa.: Lippincott Williams & Wilkins; 2001. pp. 2143-64.
Anderton JM, Helm R. Multiple joint osteonecrosis following short-term steroid therapy. Case report. J Bone Joint Surg Am. 1982; 64(1): 139-41.
Mirzai R, Chang C, Greenspan A, Gershwin ME. The pathogenesis of osteonecrosis and the relationships to corticosteroids. J Asthma. 1999; 36(1): 77-95. doi: 10.3109/02770909909065152.
McKee MD, Waddell JP, Kudo PA, Schemitsch EH, Richards RR. Osteonecrosis of the femoral head in men following short-course corticosteroid therapy: a report of 15 cases. CMAJ. 2001; 164(2): 205-6.
Agarwala SR, Vijayvargiya M, Pandey P. Avascular necrosis as a part of 'long COVID-19'. BMJ Case Rep. 2021; 14(7): e242101. doi: 10.1136/bcr-2021-242101.
Morrey BF, Adams RA, Kessler M. A conservative femoral replacement for total hip arthroplasty. A prospective study. J Bone Joint Surg Br. 2000; 82(7): 952-8. doi: 10.1302/0301-620x.82b7.10420.
Khanuja HS, Vakil JJ, Goddard MS, Mont MA. Cementless femoral fixation in total hip arthroplasty. J Bone Joint Surg Am. 2011; 93(5): 500-9. doi: 10.2106/JBJS.J.00774.