Hip-Related Complications Highly Prevalent Among Youngsters Due to Excess Steroid Use

ATK
New Delhi [India], July 19: Approximately 20% of Youngsters In The Age Group Of 20-40 Years Suffered From Hip-Related Complications After Covid Infection And Excess Steroid Usage
The Covid pandemic has changed the way the world has functioned and medical problems across the orthopedic fraternity have amplified with the increase of hip problems related to the excessive use of steroids for saving lives during the Covid pandemic. Currently, there is a surge in severe complications such as avascular necrosis associated with the hip. Timely diagnosis and treatment are key to managing these problems.
One of the most common reasons for hip replacement in India is avascular necrosis, which is brought on by the femoral head's inadequate blood supply because it receives its blood supply through one primary stream under strenuous conditions. The head, which is actually a ball and socket type of joint, will collapse following traumatic events like a fractured neck of the femur or a post-acetabular fracture. “This condition is seen in the age group starting with 20 years, and males are more commonly affected than females (3:2). The symptoms of AVN include hip pain and walking difficulty.  It can also occur as a result of steroid use, other conditions like renal problems, use of medications, or specific alignment conditions. It will cause extreme pain and disability, making it difficult for patients to move and perform daily chores. The incidence of avascular necrosis has increased five to ten times with younger patients who have received treatment for covid across the nation with this specific issue due to the Covid pandemic and the use of steroids in this situation to save the lives of people. Steroid use can result in osteoporosis, bone loss, and shattered bones. Bone loss can occur quickly when steroid drugs are used in large quantities. Steroids significantly impact how the body uses vitamin D and calcium to create bones.” said Dr Krishna Kiran, Director - Chief Primary & Revision Hip & Knee Replacement Medicover Group of Hospitals.

The incidence of avascular necrosis of the hip in both young and older patients has increased significantly and the post covid avascular necrosis is not responding to standard methods of treatment. Among 500 patients, 50 percent were youngsters in the age group of 20-40 years who were detected with this problem, and 80% were infected with Covid-19.  Men are more commonly affected by avascular necrosis than women. So young patients with avascular necrosis, the first line of treatment is to conserve the hip either through core decompression or bone marrow and stem cell infiltration and medical management using bisphosphonates. Some of them will require hip replacement surgery. Unlike elderly patients, young patients do not accept restrictions on lifestyle following hip replacement surgery and would like to sit on the floor, squat, and do activities of high performance following surgical intervention,” said Dr. Deepak Gautam, Chief Orthopedician Medicover Hospitals Navi Mumbai
“We have initiated the use of a direct anterior approach which allows the patients to sit on the floor, squat and pray and use Indian toilets with no restrictions following surgical intervention to tackle avascular necrosis. The surgery is conducted through an inter-nervous and intermuscular plane, without cutting any muscles from the front of the hip joint and the patient can be discharged on the same day or the next day following surgery. The pain and the blood loss are lower than the conventional approaches and the patient has no absolute restrictions following the surgery. No Special precautions need to be taken, but if left untreated it leads to osteoarthritis. The surgeries have been successfully performed for about 500 patients and on average 250 Surgeries have been done in a span of one year.  So, I urge everyone to stay vigilant and take utmost care of themselves.,” concluded Dr Deepak Gautam.
Although there is no known treatment for avascular necrosis, if it is discovered early by imaging techniques like X-rays or MRI, nonsurgical approaches, including activity moderation, anti-inflammatory drugs, injections, and physical therapy, may be able to halt the disease's progression.  Your doctors may have considered core decompression surgery with you as a potential therapeutic option for your avascular necrosis to prevent this result, particularly in patients thought to be too young for total hip replacement.
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