Post-Covid steroid use linked to rising hip arthritis among young adults

Doctors at the DELHI HIP 360 Conference warned of a sharp post-pandemic rise in hip arthritis and Avascular Necrosis among younger adults. Experts linked many cases to prolonged steroid use during COVID-19 treatment, increasing demand for hip replacement surgeries

New Delhi: A worrying post-pandemic orthopaedic trend has emerged across India, with doctors reporting a significant rise in cases of hip arthritis and avascular necrosis (AVN), a painful condition caused by disruption of blood supply to the hip bone, particularly among younger and middle-aged adults.

Experts at the 2nd DELHI HIP 360 Conference, held at Crowne Plaza New Delhi on Sunday, warned that the post-Covid era has accelerated hip joint damage and increased the demand for Total Hip Replacement (THR) surgeries across the country. The Delhi Orthopaedic Association organised the conference in association with the Indian Arthroplasty Association.

---

The conference brought together leading orthopaedic surgeons, arthroplasty specialists, fellows, and residents from across India to deliberate on the latest advances in Total Hip Arthroplasty (THA), complex hip reconstruction, robotic-assisted surgery, rehabilitation, and management of post-Covid hip complications.

Experts at the conference said that hospitals are witnessing a notable increase in patients presenting with severe hip pain, limping, stiffness, and difficulty in walking due to AVN and early hip arthritis. Several recent studies globally have suggested a correlation between high-dose or prolonged steroid use during COVID-19 treatment and osteonecrosis of the femoral head, especially among patients who already had underlying vascular or metabolic risk factors.

Medical experts noted that AVN, once largely seen in older adults or trauma patients, is now increasingly affecting individuals in their 30s and 40s. In many cases, delayed diagnosis allows the disease to progress silently until the hip joint collapses, eventually requiring total hip replacement surgery to restore mobility and quality of life.

Dr L Tomar, organising Chairman of DELHI HIP 360 and Director, Department of Orthopaedics and Joint Replacement at Max Hospital, Delhi, said, “We are observing a 40 per cent rise in hip replacement surgeries in younger people.

Steroids played a life-saving role during the Covid pandemic. Still, indiscriminate or prolonged use in some patients has been associated with a rise in osteonecrosis and early degenerative changes in the hip joint.” “We are now seeing relatively younger patients coming with severe hip damage, collapse of the femoral head, and advanced arthritis requiring early hip replacement surgeries,” he said.

Dr Tomar further stated that early diagnosis is critical because if AVN is detected in the initial stages, joint-preserving procedures may still be possible before complete destruction of the hip occurs. Research published in international orthopaedic journals has shown that steroid-induced AVN may develop within months after exposure, with the hip joint being the most commonly affected site.

Dr Karun Jain, Organising Secretary of the conference and a senior orthopaedic surgeon at Pushpanjali Medical Centre in Delhi, said that one of the biggest challenges with AVN is that patients often ignore early symptoms such as groin pain or stiffness, assuming it to be muscular pain. “By the time they seek medical advice, the hip joint may already have undergone irreversible collapse. Awareness, timely MRI evaluation, and early intervention can help reduce disability,” Dr Jain said.

The conference featured extensive scientific discussions on complex primary and revision hip arthroplasty, robotic and navigation-assisted hip surgery, infection prevention, difficult hip reconstructions, dysplasia management, and enhanced recovery protocols. Surgeons also discussed how advancements in implant design, minimally invasive approaches, and precision-based technologies are improving surgical outcomes and reducing recovery time.

Dr Gaurav Govil, Associate Director, Orthopaedics and Joint Replacement at Max Hospital Patparganj, said, “Total Hip Replacement today is among the most successful surgeries in modern orthopaedics. With better implants, advanced surgical planning, and faster rehabilitation techniques, patients are able to return to normal life much earlier than before. However, the focus must remain on early diagnosis and evidence-based treatment to prevent avoidable disability.” Experts at the conference stressed that India could see a substantial increase in demand for hip replacement surgeries over the next decade if early screening and preventive orthopaedic care are not strengthened. They emphasised that continuous academic collaboration, surgeon training, and adoption of modern arthroplasty techniques are essential to improve long-term patient outcomes.

The conference concluded with a strong call for greater public awareness regarding persistent hip pain after COVID recovery, responsible steroid use, and timely orthopaedic consultation to prevent severe joint damage and preserve mobility in younger populations.