City sees surge in hip replacement surgery among Covid-19 survivors
MUMBAI: City hospitals have reported a surge in hip replacement surgeries, especially in patients who were infected with Covid-19. Malubai Ghogare (64), resident of Junnar in Pune, visited JJ Hospital on Tuesday for her first follow-up post a hip replacement surgery. In February, she visited the hospital where she was diagnosed with an advanced stage of avascular necrosis (AVN) or osteonecrosis -- the death of bone tissue due to a lack of blood supply -- and its treatment necessitated a hip replacement surgery.
Hospitalised for Covid-19 in the second wave, Ghogare, said she experienced a sudden pain in the hip and thigh region in September and was unable to walk. “My legs were swollen. Initially, I visited local doctors but no one could diagnose it. It was in November that I was advised to go to a tertiary care hospital. With the third wave around, I delayed but finally had a hip replacement done,” she said.
Similar to Ghogare, Aurangabad resident Bhausaheb Navgire, 50, underwent a total hip replacement surgery on May second week. “I was hospitalised for Covid-19 a year ago. While I felt the pain in the hip region within four months of being discharged, I delayed the treatment initially. But by September, the pain progressed into stiffness and affected my mobility. I was diagnosed with AVN and advised hip replacement later,” he said. Navgire said he waited for Covid-19 cases to settle to come to JJ Hospital for the surgery.
According to doctors at the state-run JJ Hospital, many Covid-19 recovered patients have been visiting the orthopaedic department for a total hip replacement surgery. AVN is a part of ‘long Covid-19’, and studies are underway globally to understand the cause and clinical explanation behind it.
Dr Nadir Shah, associate professor, orthopaedic department, JJ Hospital, said, “In the first and second wave, life-saving corticosteroids was used in the management of Covid-19. It is one of the factors that led to the development of AVN post-recovery.”
Dr Eknath Pawar, head of the orthopaedic department at JJ
Hospital, said, “We have observed that unlike people from the metro cities, who have consulted early, people from interiors of Maharashtra delayed the treatment leading to the progression of the disease requiring a hip replacement.”
“If diagnosed at an early stage, it can be treated with medication and the disease progression can be stopped. But at a later stage, hip replacement is the only option,” he said.
Dr Shubranshu Mohanty, professor, orthopaedics, KEM HospitalParel, said before the pandemic, 60-70% of the overall hip replacement surgeries done were related to AVN. He said Covid-19 causes hypercoagulationa condition that causes the blood to clot more easily than normal. “It is one of the causes that led to AVN. In some cases, Covid-19 aggravated the already existing mild form of AVN. Steroid usage too added to rise in AVN cases in Covid-19 recovered patients,” he explained.
JJ Hospital and KEM Hospitals are among those public hospitals doing the total hip-replacement surgeries under the Mahatma Jyotirao Phule Jan Arogya Yojana .