Doctors seeing 30 per cent rise in hip surgeries in young patients post pandemic

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Doctors on Wednesday reported a significant rise of about 20-30 per cent in hip surgeries in young patients post Covid-19 pandemic, noting another potential long-term consequences of the global viral infection. Known as avascular necrosis, it is a debilitating bone disorder characterised by the death of bone tissue due to the disruption of blood supply.

AVN, also known as osteonecrosis, primarily affects the weight-bearing joints, including the hips, knees, and shoulders, but it can also affect other bones in the body. "Unfortunately we are seeing many young patients in our OPD with hip pain and during clinical and radiological examination, they were found to be suffering from avascular necrosis of the hip," Dr. Amit Chaudhry, Consultant - Fortis Bone & Joint Institute, FMRI, Gurugram, told IANS.

"Young patients present with pain in their hip joint initially on exertion and then slowly even on light activities. While there are no studies done to ascertain the increase in percentage of AVN, patients seen post-Covid have been around 20-30 per cent," he added. Doctors blamed the excess use of steroids during Covid as a possible cause of avascular necrosis of the hip joints. In addition, limited physical activity and access to healthcare during Covid also contributed to the increase. Excessive alcohol consumption, trauma, lupus, and sickle cell disease can also increase the risk.

"Complications of Covid-19 such as life-threatening thrombosis, mucormycosis required patients to get a significantly high dose of steroids during the management of their acute episode. Although necessary, the side effects of such high doses of steroids are showing in the bone health of all patients," Dr Supreet Bajwa, Hip and Knee Replacement specialist from Nexus Day Surgery Centre in Mumbai, told IANS.

"One of the many reasons for AVN of the hip is increased steroid intake which cuts off the blood supply of the femoral head ultimately leading to hip arthritis. Post the pandemic, younger patients requiring hip surgeries have increased to 15-20 cases in a month," Bajwa added. The symptoms of AVN can vary depending on the affected joint, but common signs include joint pain, stiffness, limited range of motion, and difficulty in bearing weight.

Early diagnosis and intervention are vital to prevent further deterioration and increase the chances of successful treatment. Management of the AVN of hips depends on the stage of disease. Without early treatment, the condition can lead to severe pain, loss of joint function, and even disability. Early stages can be managed with medicine and a procedure called core decompression with guarded prognosis. Late stages of the hip joint of patients get damaged and they require total hip replacement surgery, the health experts said.

"In terms of treatment, a combination of medication and surgery is often employed to manage AVN and improve patients' quality of life. Medications may include pain relievers, non-steroidal anti-inflammatory drugs (NSAIDs), and medications to address underlying conditions such as diabetes or hypertension," Dr Prajyot Jagtap, Orthopaedic Surgeon, Apollo Spectra, Mumbai, told IANS.

"Surgery options range from joint-preserving procedures, such as core decompression and bone grafting, and STEM Cells therapy, to joint replacement surgeries for advanced cases. Lifestyle modifications, such as maintaining a healthy weight, avoiding excessive alcohol consumption, and refraining from smoking, can also reduce the risk of AVN development," Dr Jagtap added.

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