Risk Factors, Pathogenesis, Diagnosis, and Treatment Options for COVID-Associated Osteonecrosis: A Systematic Review

Area of Science:

• Orthopedics
• Infectious Diseases
• Pathophysiology

Background:

• COVID-19 associated osteonecrosis is a rare but significant clinical entity.
• Limited data exists on the characteristics of patients with this condition.
• Understanding this condition is crucial given its incidence during the pandemic.

Purpose of the Study:

• To systematically review and characterize COVID-19 associated osteonecrosis.
• Identify clinical presentation and epidemiology.
• Elucidate pathophysiology, diagnostic modalities, and treatment guidelines.

Main Methods:

• Systematic review adhering to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.
• Searched three databases for relevant literature.
• Included 10 articles providing data on clinical aspects, pathophysiology, diagnosis, and treatment.

Main Results:

• Variable time between COVID-19 infection and osteonecrosis onset.
• Symptoms include joint pain and pain with weight-bearing, similar to standard osteonecrosis.
• Corticosteroid use identified as a key risk factor.
• Radiographs and MRI used for diagnosis.
• Treatment ranged from conservative management to surgical interventions like joint replacement.

Conclusions:

• Orthopaedic surgeons must be vigilant in screening for COVID-19 associated osteonecrosis.
• Knowledge of clinical presentation, pathophysiology, diagnosis, and treatment is essential for patient management.
• Appropriate screening and management strategies are vital for patients with a history of COVID-19.