Outcomes of total hip replacement in patients with Post-COVID-19 avascular necrosis

Background: Avascular Necrosis (AVN) has emerged as a potential complication in patients recovering from COVID-19, particularly those treated with corticosteroids. Total hip replacement (THR) is the standard surgical intervention for advanced AVN, but outcomes in post-COVID-19 AVN patients remain unclear due to unique post-viral sequelae. This study evaluates the effectiveness of THR in providing pain relief, restoring mobility, and enhancing quality of life in this specific patient population. Methods: A prospective observational study was conducted with 28 post-COVID-19 AVN patients undergoing THR. Baseline data included pain (VAS score), mobility (Harris Hip Score), and quality of life (SF-36). Follow-up assessments were conducted at 1, 3, 6, and 12 months post-surgery. Statistical analysis assessed changes over time, and regression analysis identified factors influencing recovery. Results: Pain levels significantly decreased postoperatively, with VAS scores dropping from 8.3±1.2 at baseline to 1.2±0.5 at 12 months (P=0.003). Functional mobility showed marked improvement, with Harris Hip Scores rising from 42.5±5.6 to 90.6±3.8 by 12 months (P=0.029). Quality of life scores across SF-36 domains also improved significantly, reflecting enhanced physical function, pain reduction, and general health. Complication rates were minimal, with deep vein thrombosis and persistent pain as the most common issues. Regression analysis indicated that age, COVID-19 severity, and corticosteroid use were associated with slower recovery. Conclusion: THR is effective in improving pain, mobility, and quality of life in post-COVID-19 AVN patients, with high patient satisfaction and minimal complications. Age, COVID-19 severity, and corticosteroid use are significant factors in recovery outcomes, highlighting the need for tailored postoperative care. This study provides foundational data to inform clinical care for post-COVID-19 AVN patients undergoing THR.