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新冠疫情后的髋关节缺血性坏死

Avascular Necrosis of the Hip after the COVID-19 Pandemic.

作者信息

Sinha Priti R, Mallick Nitin, Sahu Ramjee L

机构信息

Department of Orthopaedics, GS Medical College and Hospital, Pilkhuwa, Hapur, Uttar Pradesh, India.

Department of Orthopaedics, Santosh Medical College, Ghaziabad, Uttar Pradesh, India.

出版信息

J Pharm Bioallied Sci. 2023 Jul;15(Suppl 1):S661-S664. doi: 10.4103/jpbs.jpbs_87_23. Epub 2023 Jul 5.

Abstract

BACKGROUND AND OBJECTIVES

It is clear that COVID-19 can have a wide range of effects on the body, and the musculoskeletal system is no exception. Studies are ongoing to better understand how the virus may impact the hip bone and joint tissue. However, it is known that COVID-19 can cause inflammation and damage to various parts of the body, including the bones and joints, which could lead to pain, stiffness, and other symptoms.

MATERIALS AND METHODS

A retrospective analysis is done with ten patients admitted to the hospital due to COVID-19 and later complained of hip pain. Magnetic resonance imaging (MRI) was performed on the patients, and it was found that they had degenerative changes characterized by avascular necrosis (AVN) of the head of the femur. One of the patients had a history of previous surgery on the femur with a plate and screws and was doing well but developed AVN after contracting COVID-19.

RESULTS

Observation among these groups shows a strong association between the history of COVID-19, high levels of IgG antibodies, the presence of joint abnormalities, and moderately severe symptoms. There is no evidence of identifying autoimmune, degenerative, or AVN diseases. This set of patients responded positively to supportive therapy and anti-inflammatory drugs used in empirical treatment, which subsided joint pain and acute inflammatory symptoms.

CONCLUSIONS

It has been determined that there are significant musculoskeletal complications in COVID-19 patients, including AVN, which may be caused by the high use of steroids and microembolism leading to bone necrosis. Therefore, further studies and long-term follow-up are recommended.

摘要

背景与目的

显然,新冠病毒病(COVID-19)可对身体产生广泛影响,肌肉骨骼系统也不例外。目前正在进行研究,以更好地了解该病毒可能如何影响髋骨和关节组织。然而,已知COVID-19可导致身体各部位的炎症和损伤,包括骨骼和关节,这可能导致疼痛、僵硬及其他症状。

材料与方法

对10例因COVID-19入院且后来出现髋部疼痛的患者进行回顾性分析。对这些患者进行了磁共振成像(MRI)检查,发现他们存在以股骨头缺血性坏死(AVN)为特征的退行性改变。其中1例患者既往有股骨钢板螺钉手术史,术前情况良好,但感染COVID-19后发生了AVN。

结果

对这些患者的观察表明,COVID-19病史、高水平的IgG抗体、关节异常的存在与中度严重症状之间存在密切关联。没有证据表明存在自身免疫性、退行性或AVN疾病。这组患者对经验性治疗中使用的支持性治疗和抗炎药物反应良好,关节疼痛和急性炎症症状得到缓解。

结论

已确定COVID-19患者存在显著的肌肉骨骼并发症,包括AVN,这可能是由于大量使用类固醇和微栓塞导致骨坏死所致。因此,建议进一步研究和长期随访。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8403/10466589/da002d55f60e/JPBS-15-661-g001.jpg

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