What is avascular necrosis or bone death, a new post-Covid complication?

High dose of steroids in the treatment of the Covid can lead to avascular necrosis or bone death, doctors have said. (Representative image)(PTI)

As suggested by the name, bone death or avascular necrosis is a condition of the death of the bone tissue due to lack of blood supply. Most of the cases that the doctors are getting now are of steroid-induced bone death.

Many patients recovering from Covid-19 have complained of joint pain which has started worrying doctors that this bone death, medically known as avascular necrosis, could be another devastating post-covid complication like mucormycosis. There has been no government data regarding this as an emerging trend, but hospitals in Mumbai and Delhi have confirmed such cases.

What is bone death or avascular necrosis?

As suggested by the name, this condition denotes the death of the bone tissue due to lack of blood supply. If there is a dislocated joint or a broken bone, it can interrupt the blood flow.

What is the cause of bone death?

According to doctors the overuse of steroids during the treatment of Covid-19 is the suspect behind this unnatural bone damage. Steroids make bones soft and then cartilage reduced blood supply. While avascular necrosis might have many reasons, the cases being reported now are induced by steroids.

Symptoms

Persistent hip pain, joint pain.

When can it happen?

It will not happen immediately, as doctors have said. It may take 3 months to one year time. But if you have not been treated with steroids during your Covid-19 treatment, then you may not have any reason to worry. Also, a very high dose of steroids may lead to this malfunction.

Treatment

Medical treatment for three to six weeks is recommended. If the pain persists, then patients are advised to undergo an MRI which will detect whether it is a case of bone death or not. Surgery is required at a very advanced stage, doctors have said.

Dr Ishwar Bohra, Senior consultant, Joint replacement Surgeon, Centre for orthopaedics, BLK institute for Bone, joint replacement told ANI, "Bone death is not new, but now is being seen as a post-Covid-19 effect. Like other post-Covid sufferings, recently we are seeing in the bone and joint segment avascular necrosis of the femoral head because lots of steroids use in the Covid treatment. The hip and shoulder are the areas which should not be ignored, if there is pain."

This is only for your information, kindly take the advice of your doctor for medicines, exercises and so on.   

https://gscrochetdesigns.blogspot.com. one can see my crochet creations  
https://gseasyrecipes.blogspot.com. feel free to view for easy, simple and healthy recipes    
https://kneereplacement-stickclub.blogspot.com. for info on knee replacement

 

HIP DISORDER CURED USING STEM CELLS

A multi-specialty hospital  has successfully used stem cells 

to cure a hip joint disorder, relieving affected patients from 

expensive surgery and conservative treatment.

They have so far treated seven patients, including two non-

resident Indians (NRIs) suffering from hip joint disorder using 

their stem cells and helped them to resume normal life within 

months," Live 100 Hospital( Bangalore, India) chairman has said.

Known medically as avascular necrosis, the uncommon 

disease leads to temporary or permanent loss of blood supply 

to hip joint bone and causes disorder. If not treated early, the 

dislocation of the hip bone with joint surface can result in 

disability. Any serious injury, medications such as steroids, 

blood coagulation or excessive alcohol can cause blood loss.

Stem cell therapy has been used for the first time in the world to 

treat the hip bone disorder by rejuvenating its tissues with the 

bone marrow of the patient. Stem cells in the marrow of the 

affected bone are separated from red blood cells and blood 

plasma through a clinical process and injected into the hip joint 

of the patient said.

The private hospital  has tied up with a  laboratory to harvest 

the stem cells and transplant them through four injections over 

four weeks to restore the hip joint function lost due to damage 

to its cartilage. The stem cells also repair bone cells as they 

can differentiate between bone and cartilage cells.

The novel treatment has no bleeding or scar formation as the 

process does not involve surgery. The patient has to visit our 

hospital for a day in a week for each of the four injections the 

doctor said.

Though the treatment costs a patient Rs.350,000 currently, the 

hospital hopes to bring it down over time when awareness of 

the stem cell therapy spreads and more patients opt for the 

treatment.

Cortisone Injection (Corticosteroid Injection) of Soft Tissues & Joints

Is a cortisone injection merely a pain reliever or temporary remedy?
Corticosteroids are not pain relievers. They reduce inflammation. When corticosteroids relieve pain it is because they have reduced inflammation.


While the inflammation for which corticosteroids are given can recur, corticosteroid injections can provide months to years of relief when used properly. These injections also can cure diseases (permanently resolve them) when the problem is tissue inflammation localized to a small area, such as bursitis and tendonitis.


For what conditions are cortisone injections used?
Cortisone injections can be used to treat the inflammation of small areas of the body (local injections) or they can be used to treat inflammation that is widespread throughout the body (systemic injections). Examples of conditions for which local cortisone injections are used include inflammation of a bursa (bursitis), a tendon (tendonitis), and a joint (arthritis). Systemic corticosteroid injections are used for conditions such as allergic reactions, asthma, and rheumatoid arthritis affecting many joints.


What are the advantages of cortisone injections?
Cortisone injections can be administered easily in the doctor's office. Other advantages include the rapid onset of the medication's action, dependability, and minimal side effects. Another distinct benefit of a corticosteroid injection is that the relief of localized inflammation in a particular body area is more rapid and powerful than with traditional anti-inflammatory medications given by mouth such as aspirin. A single injection also can avoid certain side effects, notably irritation of the stomach, that accompany many oral anti-inflammatory medications.


What are the disadvantages and side effects of cortisone injections?
Disadvantages of cortisone injections are the necessity of piercing the skin with a needle as well as potential short and long term side effects. It should be emphasized that while each of these side effects is possible, they usually do not occur.


Short term side effects are uncommon, but include shrinkage (atrophy) and lightening of the color (depigmentation) of the skin at the injection site, introduction of bacterial infection into the body, local bleeding from broken blood vessels in the skin or muscle, soreness at the injection site, and aggravation of inflammation in the area injected because of reactions to the corticosteroid medication (postinjection flare). Tendons can be weakened by corticosteroid injections in or near tendons. Tendon ruptures as a result have been reported.


In persons who have diabetes, cortisone injections can elevate blood sugar. In patients with underlying infections, cortisone injections can suppress somewhat the body's ability to fight the infection and possibly worsen the infection or mask the infection by suppressing the symptoms and signs of inflammation. Generally, cortisone injections are used with caution in persons with diabetes and avoided in persons with active infections. Cortisone injections are used cautiously in persons with blood clotting disorders.


Long-term side effects of corticosteroid injections depend on the dose and frequency of the injections. With higher doses and frequent administration, potential side effects include thinning of the skin, easy bruising, weight gain, puffiness of the face, elevation of blood pressure, cataract formation, thinning of the bones (osteoporosis), and a rare but serious damage to the bones of the large joints (avascular necrosis).