Cargando…

Femoral head avascular necrosis in COVID-19 survivors: a systematic review

The current systematic review aimed to document published cases of femoral head avascular necrosis (FHAVN) post-COVID-19, to report the COVID-19 disease characteristics and management patients received, and to evaluate how the FHAVN were diagnosed and treated among various reports. A systematic lite...

Descripción completa

Detalles Bibliográficos
Autores principales: Hassan, Ahmed Abdelazim A., Khalifa, Ahmed A.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10348993/
https://www.ncbi.nlm.nih.gov/pubmed/37338665
http://dx.doi.org/10.1007/s00296-023-05373-8
_version_ 1785073782118940672
author Hassan, Ahmed Abdelazim A.
Khalifa, Ahmed A.
author_facet Hassan, Ahmed Abdelazim A.
Khalifa, Ahmed A.
author_sort Hassan, Ahmed Abdelazim A.
collection PubMed
description The current systematic review aimed to document published cases of femoral head avascular necrosis (FHAVN) post-COVID-19, to report the COVID-19 disease characteristics and management patients received, and to evaluate how the FHAVN were diagnosed and treated among various reports. A systematic literature review was performed per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines through a comprehensive English literature search on January 2023 through four databases (Embase, PubMed, Cochrane Library, and Scopus), including studies reporting on FHAVN post-COVID-19. Fourteen articles were included, ten (71.4%) were case reports, and four (28.6%) case series reported on 104 patients having a mean age of 42.2 ± 11.7 (14:74) years, in which 182 hip joints were affected. In 13 reports, corticosteroids were used during the COVID-19 management plan for a mean of 24.8 ± 11 (7:42) days, with a mean prednisolone equivalent dose of 1238.5 ± 492.8 (100:3520) mg. A mean of 142.1 ± 107.6 (7:459) days passed between COVID-19 diagnosis and FHAVN detection, and most of the hips were stage II (70.1%), and concomitant septic arthritis was present in eight (4.4%) hips. Most hips (147, 80.8%) were treated non-surgically, of which 143 (78.6%) hips received medical treatment, while 35 (19.2%) hips were surgically managed, 16 (8.8%) core decompression, 13 (7.1%) primary THA, five (2.7%) staged THA and three (1.6%) had first stage THA (debridement and application of antibiotic-loaded cement spacer). The outcomes were acceptable as regards hip function and pain relief. Femoral head avascular necrosis post-COVID-19 infection is a real concern, primarily attributed to corticosteroid usage, besides other factors. Early suspicion and detection are mandatory, as conservative management lines are effective during early stages with acceptable outcomes. However, surgical intervention was required for progressive collapse or patients presented in the late stage. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s00296-023-05373-8.
format Online
Article
Text
id pubmed-10348993
institution National Center for Biotechnology Information
language English
publishDate 2023
publisher Springer Berlin Heidelberg
record_format MEDLINE/PubMed
spelling pubmed-103489932023-07-16 Femoral head avascular necrosis in COVID-19 survivors: a systematic review Hassan, Ahmed Abdelazim A. Khalifa, Ahmed A. Rheumatol Int Systematic Review The current systematic review aimed to document published cases of femoral head avascular necrosis (FHAVN) post-COVID-19, to report the COVID-19 disease characteristics and management patients received, and to evaluate how the FHAVN were diagnosed and treated among various reports. A systematic literature review was performed per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines through a comprehensive English literature search on January 2023 through four databases (Embase, PubMed, Cochrane Library, and Scopus), including studies reporting on FHAVN post-COVID-19. Fourteen articles were included, ten (71.4%) were case reports, and four (28.6%) case series reported on 104 patients having a mean age of 42.2 ± 11.7 (14:74) years, in which 182 hip joints were affected. In 13 reports, corticosteroids were used during the COVID-19 management plan for a mean of 24.8 ± 11 (7:42) days, with a mean prednisolone equivalent dose of 1238.5 ± 492.8 (100:3520) mg. A mean of 142.1 ± 107.6 (7:459) days passed between COVID-19 diagnosis and FHAVN detection, and most of the hips were stage II (70.1%), and concomitant septic arthritis was present in eight (4.4%) hips. Most hips (147, 80.8%) were treated non-surgically, of which 143 (78.6%) hips received medical treatment, while 35 (19.2%) hips were surgically managed, 16 (8.8%) core decompression, 13 (7.1%) primary THA, five (2.7%) staged THA and three (1.6%) had first stage THA (debridement and application of antibiotic-loaded cement spacer). The outcomes were acceptable as regards hip function and pain relief. Femoral head avascular necrosis post-COVID-19 infection is a real concern, primarily attributed to corticosteroid usage, besides other factors. Early suspicion and detection are mandatory, as conservative management lines are effective during early stages with acceptable outcomes. However, surgical intervention was required for progressive collapse or patients presented in the late stage. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s00296-023-05373-8. Springer Berlin Heidelberg 2023-06-20 2023 /pmc/articles/PMC10348993/ /pubmed/37338665 http://dx.doi.org/10.1007/s00296-023-05373-8 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Systematic Review
Hassan, Ahmed Abdelazim A.
Khalifa, Ahmed A.
Femoral head avascular necrosis in COVID-19 survivors: a systematic review
title Femoral head avascular necrosis in COVID-19 survivors: a systematic review
title_full Femoral head avascular necrosis in COVID-19 survivors: a systematic review
title_fullStr Femoral head avascular necrosis in COVID-19 survivors: a systematic review
title_full_unstemmed Femoral head avascular necrosis in COVID-19 survivors: a systematic review
title_short Femoral head avascular necrosis in COVID-19 survivors: a systematic review
title_sort femoral head avascular necrosis in covid-19 survivors: a systematic review
topic Systematic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10348993/
https://www.ncbi.nlm.nih.gov/pubmed/37338665
http://dx.doi.org/10.1007/s00296-023-05373-8
work_keys_str_mv AT hassanahmedabdelazima femoralheadavascularnecrosisincovid19survivorsasystematicreview
AT khalifaahmeda femoralheadavascularnecrosisincovid19survivorsasystematicreview