23-year-old female develops avascular necrosis post Covid

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Rohit Shishodia

Even as Covid continues to take a toll on the health of people, its complications keep impacting the quality of life of those who have recovered from it. In fact, post Covid ailments are further worsening the conditions of people.

In such a case, a 23-year-old female developed avascular necrosis (AVN) in four joints – both knees and hips. She remained bed-ridden till the time her treatment started at HCMCT Manipal Hospitals Dwarka, Delhi.

AVN is a serious condition that results in death of bones due to loss of blood supply. However, with timely and quick intervention she was successfully treated by the doctors.

Initially, she experienced mild pain in the right hip three weeks post Covid-19 recovery. She misread symptoms of pain with after effects of Covid .

However, her condition continued to worsen over a period of time She could not take pressure on the right leg and the pain gradually shifted to her left hip too followed by right and left knees.Upon consulting Dr Rajeev Verma , HOD ,Orthopedics and Joint Replacement, HCMCT Manipal Hospitals, she was subjected to few MRI 's and radiographs.

While amidst the pandemic, AVN cases were on the rise. Manipal hospital has treated six patients of AVN successfully in a month.  This case was the first for the team of doctors treating the patients with AVN in hips and knees.

However, doctors say that it is too early to attribute it as post Covid compilation but they have linked AVN to steroids which are used for managing covid infection.

It was discovered that she had  AVN in both her hip joints and knee joints for which she was recommended for core decompression surgery.

Dr Verma pointed out that the leading cause for the AVN is use of high dose of steroids for the treatment of severe Covid related pneumonia. Several studies have shown that Covid may also result in hypercoagulability – a condition which has an independent risk factor for developing AVN, he added.

"After a few months of recovery from Covid, the patient experiences joint pains, mostly in hip and knee area. Over a period of time, the pain can restrict their physical activity with debilitating outcomes in terms of bone health. Aggressive procedures are required for treatment to regain mobility,” he said.

Dr Verma, said, “The patient had come to us in a critical condition as she developed swelling and pain in both hips and knees and was bed-ridden. After performing a three-hour long surgery, we were quite satisfied with the post-operative response as the patient reported significant improvement in her symptoms.”

“We are happy that the patient is doing well and recovering at the expected pace. We owe the success of this procedure to our top-notch infrastructure and patient’s determination to fight the symptoms ” he explained.


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