Just as the virus can mutate, so can coronavirus disease 2019-related bone necrosis!

Background The pandemic of COVID-19 virus had led to another pandemic of avascular necrosis. Aim To evaluate the altered clinical and radiological presentation of COVID-19-related AVN of the hip. Methods This study included 42 patients with AVN of the head of the femur who were presented to the outpatient clinic of Kafr El Sheikh University Hospital. Patients were classified into three main groups. The first group included patients who had COVID infection and received steroid therapy for their pulmonary manifestations. The second group included patients who had COVID infection without receiving steroid therapy. The final group included patients who had AVN of the hip after receiving COVID vaccination without taking any steroid therapy. Results The study included 42 patients who had AVN related to COVID-19 infection. Patients who had COVID-19 infection were more susceptible to AVN development at (a) lower threshold dose of steroid (900 g) and (b) earlier onset of presentation (less than a month). Conclusions To conclude, there is a silent epidemic of cases presenting daily in our clinics with COVID-19-related AVN.