Incidence and Mechanisms of Avascular Necrosis of the Femoral Head in Post-COVID-19 Patients: A Comprehensive Observational Study

Abstract

COVID-19 has been linked to various long-term complications affecting multiple organ systems, including the musculoskeletal system. This study investigates the incidence and risk factors of avascular necrosis (AVN) of the femoral head among COVID-19 survivors, with a focus on the role of corticosteroid therapy and COVID-19 severity. Conducted at a tertiary care center, the observational study classified AVN cases using the FICAT and ARLET staging system and examined the correlation between steroid use and AVN progression. The results indicate a higher prevalence of AVN in patients with moderate to severe COVID-19 and a notable association between corticosteroid therapy and AVN onset. The accelerated onset of AVN in these patients suggests that COVID-19-induced hypercoagulability, combined with steroid usage, may contribute to rapid ischemic damage to bone tissue. The findings underscore the importance of early detection and regular follow-up in COVID-19 survivors, particularly those treated with steroids, to prevent progression to advanced AVN stages. This study highlights the need for cautious steroid administration in COVID-19 treatment and suggests directions for future research on preventive measures and alternative therapies to mitigate AVN risk in post-COVID-19 care