Steroid use in managing covid leads to a surge in Avascular Necrosis

Avascular necrosis is the death of bone tissue due to a lack of blood supply. Also called osteonecrosis, it can lead to tiny breaks in the bone and cause the bone to collapse. The process usually takes months to years. A broken bone or dislocated joint can stop the blood flow to a section of bone. The causes include broken bones, dislocated hips, radiation therapy, patients on steroids for medical use and alcohol misuse. Off late, steroids administered during covid has resulted in more such cases

Dr. J V Srinivas, Lead Consultant – Orthopedics & Joint Surgery, Aster RV Hospital said, “Normally in precovid times, we used to see only 3 to 4 patients every year with this condition. But in post covid times, the numbers have quadrupled. Covid patients given high doses of prescribed corticosteroids to save their lives are now at risk of avascular necrosis.

Usually, avascular necrosis is a condition affecting the elderly patients suffering from uncontrolled diabetes and rheumatoid arthritis, among other conditions “Since covid we are getting healthy, young individuals in their 20s and 30s with AVN of the hip,” revealed Dr Srinivas, talking about the shift in patient profile. Patient history and detailed examination disclose one common link-steroid use for Covid.

In the beginning stages of the disease, the symptoms are usually nonexistent and negligible. As the condition worsens, affected joints might hurt only when putting weight on them. But those who suffered with covid and steroids were noted to have advanced stages of AVN by the time they have been diagnosed. Initially the implications include Intermittent pain that appears and eases when you put pressure on your bone and then remove the pressure, Increasing pain and stiff joints and limited range of motion. When untreated, avascular necrosis worsens. Eventually, the bone can collapse. Avascular necrosis also causes bone to lose its smooth shape, possibly leading to severe arthritis.

Dr Srinivas said, “managing a healthy lifestyle helps in keeping the avascular necrosis at bay. Limited use of alcohol, monitoring the use of steroids, healthy diet and cutting down cholesterol, quitting smoking can reduce the risk.