ABSTRACT
Objective: To study the clinical signs and methods of treatment of patients with COVID-19-related femoral head aseptic necrosis. Method(s): There were 80 patients (65 men and 15 women) with COVID-19-related femoral head aseptic necrosis. In the first days of the disease, pain was noted in the groin area and hip joint, which increased after 2-3 days. Because of the pain, the physical activity of patients was sharply reduced, some patients could not walk. A characteristic early clinical sign of femoral head aseptic necrosis after COVID-19 infection in 60% was observed limitation of internal rotational movements of the thigh in the area of the hip joint, limitation of external rotational movements of the thigh was noted in 40% of patients with stages 1-2 of the disease. Both internal and external rotational movements of the thigh in the area of the hip joint 100%. All patients had 3-4 stages of the disease. Depending on the stage of the disease, various methods of treatment were carried out. Result(s): In the early stage 1-2 of the disease, patients were prescribed anti-inflammatory drugs (Dexalgin), therapeutic blockades and injections, physiotherapy, manual and underwater massage, exercise therapy, plasma therapy. If conservative treatment was ineffective, surgical treatment was performed. Patients underwent our proposed method, a minimally invasive decompressive, revascularization surgery in the head of the femur using stromal vascular fraction, bone marrow concentrate, and using bioceramics. In stage 3-4, hip arthroplasty is used. Conclusion(s): Clinical signs of COVID-19-related femoral head aseptic necrosis make it possible to determine the degenerative-destructive changes and the choice of treatment method. In stages 1-2 decompressive, revascularization operations were performed in the area of the femoral head using stromal vascular fraction, bone marrow concentrate, and with the use of bioceramics. In stages 3-4 of the disease, we perform arthroplasty.