Steroid-Induced Osteonecrosis of the Femoral Head in Northern Nigeria: Reasons for Steroid Use and Outcome of Total Hip Replacement.

Abstract

Background: Glucocorticoid use and alcoholism constitute over 90% of all non-traumatic causes of avascular necrosis (AVN) of the head of the femur (HOF). Total hip arthroplasty (THA) is the treatment of choice for end-stage AVN of HOF. In Nigeria, patients use oral corticosteroids for many medical and social reasons. The purpose of this study was to analyse various reasons why steroids are used and to document the early outcomes of THA in steroid-induced osteonecrosis of HOF in northern Nigeria.

Materials and methods: This prospective interventional multicentre study was conducted at various government hospitals across northern Nigeria between January 2021 and June 2025. The reasons for taking steroids were documented in this study. The functional outcomes after THA were assessed using the Harris Hip Score (HHS), and patients' overall satisfaction was also reported using a 5-point Likert scale. Statistical analyses were performed using Statistical Package for the Social Sciences version 23 for Windows.

Results: Most of the patients, 102 (73.9%), use steroids for social reasons. Only 36 (26.1%) of the patients used the drugs for medical reasons. There was a significant improvement in postoperative HHS (P = 0.000), and most of the patients were satisfied with the treatment.

Conclusion: Most patients with steroid-induced AVN of HOF in northern Nigeria used steroids for social reasons. The outcome of THA for steroid-induced osteonecrosis of the HOF was excellent, and most patients were satisfied with the result.