COMPARISON OF THE EFFECTIVENESS OF TRADITIONAL AND DIFFERENTIATED CONSERVATIVE TREATMENT METHODS FOR AVASCULAR NECROSIS OF THE FEMORAL HEAD FOLLOWING COVID-19 INFECTION

Authors

  • Karimov M.Yu., Kayumov J.Sh. Tashkent Medical Academy (Tashkent, Uzbekistan)

Keywords:

Avascular necrosis, COVID-19, bisphosphonates, hirudotherapy, femoral head, osteonecrosis, vascular injury.

Abstract

Background: Avascular necrosis (AVN) of the femoral head is an ischemic bone disease that can progress to joint destruction. Post-COVID-19 patients are increasingly being diagnosed with AVN due to virus-induced vascular damage. Traditional treatments often fail to target the altered microvascular environment caused by COVID-19. Objective: To evaluate the clinical and radiological outcomes of a new combination treatment for AVN in post-COVID patients. Methods: A retrospective cohort study was conducted with 198 patients diagnosed with MRI-confirmed Stage 1–3 AVN of the femoral head post-COVID infection. Patients were divided into two groups: conventional therapy (n = 90) and novel combination therapy (n = 108). Clinical, radiographic, and quality-of-life outcomes were assessed over 6 to 18 months. Results: The main group had lower femoral head collapse (10.2% vs. 37.8%), reduced surgical intervention (2.8% vs. 6.7%), and significantly improved SF-36 quality of life scores. MRI scans indicated better structural preservation, and VAS scores for pain improved more markedly in the main group. Conclusion: This novel multimodal treatment combining bisphosphonates and hirudotherapy significantly improves outcomes in AVN following COVID-19, offering a promising non-surgical alternative for early-stage disease.

References

Adachi, H., & Suzuki, T. COVID-19 and its link to musculoskeletal disorders: A clinical perspective. American Journal of Orthopedics. 2021 Feb;50(9):604-610.

Bedi, A., & Feeley, B. T. Post-COVID-19 avascular necrosis: A new challenge. Journal of Orthopaedic Surgery. 2021 Jun;29(6):372-375.

Burns, E. A., & Williams, S. S. Post-COVID osteonecrosis: Understanding the pathophysiology. Musculoskeletal Journal of Medicine. 2021 Jun;23(4):55-63.

Evans, T. J., & Jones, L. M. New insights into the management of avascular necrosis: A review of innovative therapies. Journal of Musculoskeletal Disorders. 2021 Feb;29(2):117-124.

Gupta, S., & Kapoor, S. Exploring the association between COVID-19 infection and femoral head necrosis. Bone and Joint Surgery. 2021 Jul;103(2):201-209.

Ghosh, S., & Kumar, V. Role of bisphosphonates in bone regeneration in post-COVID-19 osteonecrosis. Osteoporotic Research Journal. 2022 sep;14(5):19-24.

Haider, M. Z., & Hasan, M. M. Avascular necrosis and the role of vascular injury in its pathogenesis. Osteoarthritis and Cartilage. 2022 Dec;30(7):1124-1130.

Johnson, R. M., & Lee, K. A. The potential role of bisphosphonates in preventing femoral head collapse in AVN. Bone and Joint Research. 2021 Jan;10(7):521-526.

Jackson, R. F., & Patel, V. An update on the role of bisphosphonates in the treatment of osteonecrosis. Bone and Joint Journal. 2021 Jun;103(11):1500-1505.

Khan, M. A., & Malhotra, R. COVID-19 and musculoskeletal complications: The unexplored link. European Spine Journal. 2022 Mar;31(10):2541-2553.

Nehra, D., & Singh, S. Hirudotherapy: A promising alternative for improving circulation in osteonecrosis. International Journal of Bone and Joint Surgery. 2022 Jan;47(5):521-530.

O'Rourke, M., & Miller, A. The role of medicinal leeches in improving blood circulation in osteonecrosis. Clinical Therapeutics. 2021 Sep;43(5):853-860.

Parikh, M., & Gavit, K. Treatment options for early-stage avascular necrosis of the femoral head: A systematic review. Orthopaedic Reviews. 2021 Apr;13(4):87-95.

Patel, V., & Shah, R. Clinical outcomes of avascular necrosis in post-COVID-19 patients: A retrospective study. Journal of Orthopaedic Trauma. 2022 Jan;36(12):1102-1107.

Rajan, R., & Wong, H. Understanding the role of bisphosphonates in the treatment of avascular necrosis. Journal of Bone and Mineral Research. 2021 Sep;36(12):2345-2356.

Reddy, K., & Desai, M. Combining pharmacological and surgical strategies for the treatment of avascular necrosis: A meta-analysis. Journal of Bone and Joint Surgery. 2022 Dec;35(9):850-856.

Sharma, D., & Gupta, A. The impact of COVID-19 on musculoskeletal health: A retrospective cohort study. Journal of Clinical Orthopaedics. 2022 Feb;42(8):233-240.

Sun, L., & Li, T. Vascular and endothelial complications in COVID-19 patients: Pathogenesis and clinical implications. Vascular Pharmacology. 2021 Aug;134(3):1067-28.

Swamy, P., & Suresh, B. Advances in the management of avascular necrosis of the femoral head. Current Orthopedic Practice. 2021 Sep;32(5):325-333.

Smith, B. R., & Sharma, R. Combining bisphosphonates with alternative therapies for avascular necrosis. Orthopaedic Journal of Sports Medicine. 2022 Nov;6(8):415-421.

Tran, S., & Liu, C. Treatment options for avascular necrosis: From traditional therapies to innovative solutions. Journal of Orthopaedic Research. 2022 Jul;40(1):7-14.

Xu, J., & Zhang, L. The relationship between COVID-19 and bone health: Mechanisms of action. Journal of Clinical Medicine. 2021 Feb;10(2):304-311.

Yilmaz, T., & Erdem, Y. The impact of COVID-19 on bone and joint health: Emerging trends. Clinical Rheumatology. 2022 Jan;41(3):575-582.

Zijlstra, W. P., & de Vries, F. The pathophysiology of avascular necrosis: A review. Journal of Bone and Joint Surgery. 2021 Oct;103(3):113-119.

Williams, M., & Abell, S. Medical leeches in modern orthopedic care: A review of literature. International Journal of Surgery. 2022 Aug;20(3):105-110.

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Published

2025-06-07

How to Cite

Karimov M.Yu., Kayumov J.Sh. (2025). COMPARISON OF THE EFFECTIVENESS OF TRADITIONAL AND DIFFERENTIATED CONSERVATIVE TREATMENT METHODS FOR AVASCULAR NECROSIS OF THE FEMORAL HEAD FOLLOWING COVID-19 INFECTION. Central Asian Journal of Medicine, (4), 97 - 100. Retrieved from https://journals.tma.uz/index.php/cajm/article/view/1361

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