Evidence map›Paper›PMID 40211352›Full record

ArticleJournal of orthopaedic surgery and research2025

Osteonecrosis of the femoral head in post-COVID-19 patients: a retrospective comparative study.

Jichang Seong, Abduaziz Babakulov, Saodat Asilova, Babamukhamedova Shakhnoza, Makhmudova Nodira, Akbarjon Mirzayev

Erratum issuedAbstract readComparative Study
PubMed Full text at PMC Publisher
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Article in Journal of orthopaedic surgery and research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

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2 · The registry

The trial behind it

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3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 1 synthesis or guideline pooled it.

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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

6 authors.

Jichang SeongSchool of Medicine, Central Asian University, Tashkent, 111221, Uzbekistan.
Abduaziz BabakulovDepartment of Orthopedics and Traumatology, Akfa Medline University Hospital, Tashkent, 100211, Uzbekistan.
Saodat AsilovaDepartment of Orthopedics and Traumatology, Kimyo University Hospital, Tashkent, 100121, Uzbekistan.
Babamukhamedova ShakhnozaSchool of Medicine, Central Asian University, Tashkent, 111221, Uzbekistan.
Makhmudova NodiraSchool of Medicine, Central Asian University, Tashkent, 111221, Uzbekistan.
Akbarjon MirzayevDepartment of Orthopedics and Traumatology, Akfa Medline University Hospital, Tashkent, 100211, Uzbekistan. akbar.orthopedic@gmail.com.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe COVID-19 pandemic has claimed many lives and continues to impact individuals through post-COVID-19 conditions. Osteonecrosis of the femoral head (ONFH) is increasingly recognized as a major post-COVID-19 complication, yet most studies are limited to case reports and small series. This study aimed to evaluate COVID-19-related factors potentially contributing to ONFH development in post-COVID-19 patients.

methodsA retrospective analysis was conducted on 84 patients with ONFH and a confirmed history of COVID-19. Baseline characteristics were collected, and patients were categorized into the following groups for comparative analysis: (1) vaccinated vs. unvaccinated, (2) unilateral vs. bilateral ONFH, (3) dexamethasone (DEX) and methylprednisolone (MPS) vs. DEX therapy, and (4) Association Research Circulation Osseus (ARCO) stage 2 vs. stage 3. Group differences and associations were analyzed.

resultsThe DEX and MPS-treated group had a greater extent of COVID-19 lung involvement compared to the DEX-treated group (59.2% vs. 36.3%, p = 0.002), as well as longer hospital stays in both general ward (14.2 days vs. 10.6 days, p = 0.018) and ICU (5.4 days vs. 3 days, p = 0.017). The DEX and MPS-treated group also had a longer duration of steroid therapy (19.3 days vs. 12.3 days, p < 0.001) and received higher DEX-equivalent cumulative steroid doses (380 mg vs. 125 mg, p < 0.001). Notably, ONFH symptoms developed earlier in the DEX and MPS-treated group compared to the DEX-treated group (7.5 months vs. 12 months, p = 0.004). Multivariable logistic regression analysis identified cumulative steroid dose as the sole predictor of ONFH severity (OR: 1.015, 95% CI: 1.001-1.028, p = 0.032), with ARCO stage 3 patients receiving higher cumulative steroid doses than stage 2 patients (240 mg vs. 126 mg, p = 0.018).

conclusionsOur study demonstrated that cumulative steroid dose is the primary determinant of ONFH severity in post-COVID-19 patients. Additionally, combined use of corticosteroids may accelerate the onset of ONFH, highlighting the need for cautious steroid management in COVID-19 patients.

Indexed as

COVID-19Femur Head NecrosisAdultAgedDexamethasoneFemaleGlucocorticoidsHumansMaleMethylprednisoloneMiddle AgedRetrospective StudiesDexamethasoneGlucocorticoidsMethylprednisoloneAvascular necrosisCOVID-19DexamethasoneFemoral headMethylprednisoloneOsteonecrosisSteroidVaccination

Identifiers

PMID40211352
PMCPMC11984230

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.