Osteonecrosis of the femoral head induced by a new coronavirus infection

I.B. Bashkova^1,2, I.V. Madyanov^1,3, A.S. Mikhailov^{2 1}Chuvash State University named after I.N. Ulyanov, Cheboksary

²Federal Center for Traumatology, Orthopedics and Arthroplasty, Cheboksary

³Chuvash Republic Postgraduate Doctors’ Training Institute, Cheboksary

Osteonecrosis (ON) is a severe disabling disease that commonly develops in persons of young working age and is associated with the death of bone cells in a certain area of bone tissue, usually provoked by a local circulationdisorder. ON commonly develops in the femoral head. The following customary factors that can provoke the ON progression of the femoral head include: traumatic hip injury, surgical interventions on the hip, hip dysplasia, immune inflammatory rheumatic diseases, various coagulopathies, hyperlipidemia, genetic abnormalities, chronic liver diseases, treatment with glucocorticoids (GC), radiation and polychemotherapy, alcohol abuse and etc. According to the literature, there are the following pathogenetic factors associated with COVID-19 and causing bone destruction: coagulopathy, endothelial dysfunction and endotheliitis, cytokine hyperproduction, activation of the complement system, thrombotic microangiopathy, hypoxia and a number of other mechanism s, including the direct viral damaging effect on the trabecular and cortical bone tissue. The article presents the own clinical case describing the development of ON after a new coronavirus infection. Thus, all persons who have undergone COVID-19, regardless of the severity and the GC use / absence of use, should be considered as vulnerable to the ON progression and be included in the risk group for this complication.

Keywords: avascular necrosis, osteonecrosis, coronavirus infection, COVID-19, long-term effects of COVID-19.

For citation: Bashkova I.B., Madyanov I.V., Mikhailov A.S. Osteonecrosis of the femoral head induced by a new coronavirus infection. RMJ. 2022;6:71–74.