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

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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.

About the authors

Alexander N. Torgashin

National Medical Research Center for Traumatology and Orthopedics named after N.N. Priorov

Author for correspondence.
Email: dr.torgashin@gmail.com
ORCID iD: 0000-0002-2789-6172

Cand. Sci. (Med.)

Russian Federation, 10, Priorova str., Moscow, 127299

Svetlana S. Rodionova

National Medical Research Center for Traumatology and Orthopedics named after N.N. Priorov

Email: rod06@inbox.ru
ORCID iD: 0000-0002-2726-8758

Dr. Sci. (Med.), Professor, Scientific and Clinical Center for Osteoporosis

Russian Federation, 10, Priorova str., Moscow, 127299

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3. Цель обработки персональных данных: анализ пользовательской активности с помощью сервиса «Яндекс.Метрика».

4. Категории субъектов персональных данных: все Пользователи Сайта, которые дали согласие на обработку файлов «cookie».

5. Способы обработки: сбор, запись, систематизация, накопление, хранение, уточнение (обновление, изменение), извлечение, использование, передача (доступ, предоставление), блокирование, удаление, уничтожение персональных данных.

6. Срок обработки и хранения: до получения от Субъекта персональных данных требования о прекращении обработки/отзыва согласия.

7. Способ отзыва: заявление об отзыве в письменном виде путём его направления на адрес электронной почты Оператора: info@rcsi.science или путем письменного обращения по юридическому адресу: 119991, г. Москва, Ленинский просп., д.32А

8. Субъект персональных данных вправе запретить своему оборудованию прием этих данных или ограничить прием этих данных. При отказе от получения таких данных или при ограничении приема данных некоторые функции Сайта могут работать некорректно. Субъект персональных данных обязуется сам настроить свое оборудование таким способом, чтобы оно обеспечивало адекватный его желаниям режим работы и уровень защиты данных файлов «cookie», Оператор не предоставляет технологических и правовых консультаций на темы подобного характера.

9. Порядок уничтожения персональных данных при достижении цели их обработки или при наступлении иных законных оснований определяется Оператором в соответствии с законодательством Российской Федерации.

10. Я согласен/согласна квалифицировать в качестве своей простой электронной подписи под настоящим Согласием и под Политикой обработки персональных данных выполнение мною следующего действия на сайте: https://journals.rcsi.science/ нажатие мною на интерфейсе с текстом: «Сайт использует сервис «Яндекс.Метрика» (который использует файлы «cookie») на элемент с текстом «Принять и продолжить».