Osteonecrosis in Patients Recovering from COVID-19: Mechanisms, Diagnosis, and Treatment at Early-Stage Disease (Review)

Alexander N Torgashin,Svetlana S Rodionova

doi:10.17816/2311-2905-1707

Abstract

Background. Aseptic bone necrosis (osteonecrosis), as a consequence of the ongoing coronavirus disease-2019 (COVID-19) pandemic, is increasingly becoming the cause of severe pain syndrome in the hip, knee, and shoulder joints with disruption of their function. The discussion of the pathogenesis of post-COVID-19 osteonecrosis, possibility of its diagnosis, and treatment at early stages continue. As COVID-19 affects young and able-bodied people, the diagnosis and treatment of this form of aseptic necrosis at early stages have great social and economic importance. Methods. The literature search was conducted in the databases of eLIBRARY, PubMed, and Scopus. The search depth was 10 years. Selected publications were related to the early diagnosis and treatment of aseptic necrosis following COVID-19. Results. The form of osteonecrosis that developed after COVID-19 should now be classified according to ICD-10 as M87.3 (another secondary osteonecrosis). The review provides data on the possible mechanisms of osteonecrosis development in patients who had COVID-19, explains the role of MRI for the early detection of the pathology, provides the results of treatment that can influence both pathogenesis mechanisms, and leads to disease regression if treatment was initiated at an early stage. Conclusions. Improving the doctors awareness about the pathogenesis, diagnostic methods, and treatment of early disease stages will reduce the risk of developing an advanced stage of aseptic necrosis post-COVID-19, slow down the progression of the pathology, and delay or even prevent the need for joint replacement. Our concern is based on the continuation of the pandemic, the observed fact of the dramatic increase in the frequency of aseptic necrosis post-COVID-19, and the number of total arthroplasties in young and middle-aged people for aseptic necrosis of the femoral head.

Highlights

Aseptic bone necrosis, as a consequence of the COVID-19 in the conditions of the ongoing pandemic, is increasingly becoming the cause of severe pain syndrome in the hip, knee, shoulder joints with violation of their function
Selected publications related to the early diagnosis and treatment of aseptic necrosis after COVID-19
The form of osteonecrosis that developed after COVID-19 should be classified according to ICD-10 as M87.3 — another secondary osteonecrosis

Summary

Background

Aseptic bone necrosis (osteonecrosis), as a consequence of the COVID-19 in the conditions of the ongoing pandemic, is increasingly becoming the cause of severe pain syndrome in the hip, knee, shoulder joints with violation of their function. The discussion of the pathogenesis of post-COVID-19 osteonecrosis, the possibility of its diagnosis and treatment at early stages continues. Given the scale of the COVID-19 infection spread among young and able-bodied people, the diagnosis and treatment of this form of aseptic necrosis at early stages have great social and economic importance. Improving the doctors’ awareness about the pathogenesis, methods of diagnosis and treatment of early stages will reduce the risk of developing an advanced stage of aseptic necrosis after COVID-19, slow down the progression of the pathology, delay or even prevent the need for joint replacement. У 39% пациентов с SARS-CoV-2 остео некроз головки бедренной кости развивался в течение нескольких месяцев после атипичной пневмонии [7]. Цель обзора — обобщение данных литературы о механизмах развития асептического некроза после перенесенной инфекции COVID-19, методах диагностики и лечения на ранних стадиях заболевания

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