- There has been a rise in post-COVID avascular necrosis (AVN) of hipcases among young adults, resulting in painful hips
- AVN refers to the death of a bone tissue due to lack of blood supply
- Use of high-dose steroids during treatment of COVID has led to these cases
- Patient was infected with COVID last year and was given high dose of steroids over a short period of time
- Stem cell implantation was used along with core decompression technique
- Patient is doing well now,and his pain has been relieved
At 27 years of age, IT professional, Mr. Gaurav (name changed) was not expecting a hip pain and was left worried when the pain lasted for over 3 months. He visited Indian Spinal Injuries Center (ISIC) in New Delhi andwas diagnosed with bilateral avascular necrosis (AVN) of femoral head ofboth hip jointsafter undergoing an X-Ray and MRI test.AVN refers to the death of a bone tissue due to lack of blood supply.
There has been an increase in post-COVID AVN cases among young adults these days.Use of high-dose steroids during treatment for coronavirus has led to several AVN cases recently, according to doctors at ISIC.
“In this case, the patient had avascular necrosis of the femoral head which is due to disruption of blood supply to the proximal femoral head.While one side of the hip presented with stage 2 of AVN, the other side had stage 3 damage, making it a complex case as we faced a double challenge of preserving the function and structure of hip as well as to relieve the pain.The patient’s medical history also indicated that he was infected with COVID-19 in February last year and was administered high doses of steroids, which would have led to his condition,” says Dr Vivek Mahajan, senior consultant, Orthopaedic and Joint Replacement Surgeon, Indian Spinal Injuries Centre.
On the surgical procedure done to treat the patient’s condition, Dr Vivek Mahajan, senior consultant, Orthopaedic and Joint Replacement Surgeon, Indian Spinal Injuries Centre said that stem cell implantation was used along with core decompression of both the affected femoral heads. Core decompression is a surgical procedure that involves surgical drilling into the area of dead bone near the joint.
“Since AVN of the femoral head is a painful, progressive disease that can lead to limited mobility and early hip replacement in young patients, we decided to go for stem cell therapy as it helps prevent hip replacements and has shown good results in the past as well. It was an autologous stem cell implantation, i.e., patient’s own stem cells were used to repair the dying bone.Stem cells were injected into the affected part after doing the core decompression. This not only allowed us to prevent the hip replacement but also preserve the function and structure of the hip. Currently, the patient is doing well, and his pain has been relieved,” said Dr Vivek Mahajan.
According to the doctor, what made this case special was that the patient was very young and had no history of hip pain. He complained of hip pain only after six months of recovering from COVID-19.
Besides COVID medications, AVN could occur due to joint or bone trauma, cancer treatments involving radiation and excessive intake of alcohol. Unmonitored intake of steroids and long-term usage of certain medications that increase bone density can also contribute to the condition. Some medical conditions associated with AVN are diabetes, HIV/AIDS, and sickle cell anemia.
Dr Mahajan advises people in general to not ignore a persistent hip pain as that may be associated with this painful condition. “If you are having groin or hip pain,you should see a doctor immediately to diagnose this condition at an early stage. Apart from this, one should avoid steroids use without doctor’s prescription or advise, especially for body building. There is also no need to worry for those affected by AVN as early diagnosis and treatment can help in preventing hip replacement.”
“We congratulate the whole team of doctors and Dr Vivek Mahajan especially for leading this whole operation. The patient and his family are happy with the outcome of the surgery. The goal of ISIC is to provide exceptional services and advanced treatment for spinal injuries and deformities through our scientific expertise and excellent team of doctors. This case will also create awareness of stem cell therapy and the unmonitored use of steroids. This is a success story for the entire ISIC family and will motivate us to make efforts towards the health and happiness of all our patients, said Sugandh Ahluwalia, Chief of Strategy, Indian Spinal Injuries Centre, New Delhi.