Persisting Impact of Covid-19 on Lower Limb Joints

September 12, 2022

We have been through the devastating effects of the COVID pandemic which has impacted the health and well-being of every person and family. It is moreover lurking anxiety that we haven’t seen the end of COVID-related problems yet. Persisting joint pain has become more frequent in our younger generations these days. Lack of outdoor physical activities and exercise has contributed to this. However, some problems are directly related to the longer-term effects on our musculoskeletal system after having contracted COVID.

Hip joint-related complaints are certainly on the rise in recent times. The most significant emerging hip joint disease post- COVID is Avascular Necrosis (AVN) in the ball of the hip. It occurs as a result of bone death due to a lack of blood supply to the bone, eventually leading to bone collapse and arthritis. Prolonged usage of high-dose steroid medications during hospitalization is one of the root causes of this, further exaggerated by people who have some genetic predispositions. Excessive consumption of alcohol and long-term usage of plant extracts or traditional medicine can lead to AVN as well.

There is a significant increase in the number of knee pain, back pain or muscle tightness cases post-pandemic. Poor posture due to working from home is the root cause of this. Many of us have very subtle abnormalities of bone shape that are passed on to us in our genetics. These would not have normally caused problems, but come to the surface when combined with a bad lifestyle. Obesity and increased screen time have further exacerbated posture-related problems for people. Unlike office spaces, our home seating is often not ergonomically designed, even though it might seem more comfortable. It causes increased joint pressure and muscle weakness which leads to early wear and tear of the joint surface.

If diagnosed at an early stage, both AVN of the hip and early knee arthritis could be completely reversible. A detailed clinical examination by a specialist should come first as unnecessary X-rays can be avoided. New generation MRIs can see all tissues with better contrast and can diagnose the above problems early. It is important not just to see the marketed resolution of the MRI, but to see whether the specialist unit at the respective hospital report cartilage scan screening on MRI, which is available only in select centres that do “Cell Therapy treatments and Joint Regeneration” work. Newer drugs administered as bone injections or Bone Marrow derived Stem cells help regenerate and reverse AVN in cases where previously Joint Replacement was (and still is) being done. Hence diagnosing at an early stage is important such that Total Hip Replacement can be prevented. 50% of the time, AVN affects bilateral hip joints. It is therefore important to assess the other hip and rule out the chances of disease involvement simultaneously. Total hip replacement is a viable and permanent solution, but in cases at the last stage (less than 20% of cases at first diagnosis) where bone involvement is severe and arthritis is already established. The relief however is that good technology is available for this major operation too. Even when done at younger ages, long-term survival of potentially greater than 50 years can be ensured with the available techniques by a specialist. Cartilage surface damage in the knee can also be completely cured cartilage regeneration procedure by using bone marrow stem cells. It is carried out by key-hole or arthroscopic technique which means no stitches from surgery of the joint and often no need for hospitalization over a day.

Finally, the main take-home is that total prevention is much better than medical or operative solutions for a cure. We, at our ‘comprehensive’ centre now have the technology to diagnose muscle and posture-related problems by evaluating the body balance and walking pattern very easily in the out-patient department itself and often avoiding more expensive testing. A pressure sensor mat is being developed indigenously for this purpose. Most of cases, we can prevent arthritis by implementing a holistic approach like promoting a healthy lifestyle, home- exercise techniques and without prescription medicines. Patients hence need to be aware, not neglect emerging problems at an early stage and consciously participate in improving their health standards with scientifically proven techniques.

By Dr Yogeesh D Kamat
Dr Yogeesh D Kamat, Consultant Hip, Knee & Sports Injury Surgeon, KMC Hospital, BR Ambedkar Circle, Mangaluru.
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Comment on this article

  • Ben D'Souza Prabhu, Mangalore, Bombay Bandra now in Canada

    Thu, Sep 15 2022

    I am thankful for this, our dear Dr Yogeesh D Kamath for such a useful informative write-up on this issue ! I am of this opinion that you have taken the trouble of explaining very well about this main issue. I owe a great happiness for your patients and I pray that our Almighty to bestow upon you a very advanced age for the benefit of mankind !!!

  • Dev, Mangalore

    Wed, Sep 14 2022

    Very informative article about the diseases caused directly or indirectly by medications too. Many people were imprisoned inside their homes or flats in cities & they gained weight due to lack of exercise or immobile lifestyle. Village people never had this problem as they were busy & farmers were busy in their fields. Secondly the new noninvasive treatment procedures are a boon to the patients as explained by doctor. I've seen many people gaining weight more than normal possible way. Doctor should refer them to endocrinologists as thyroid might have been affected due to the toxicity in these jabs. Some are complaining about neurological problems milder to severe form only after the jabs. Those who didn't had steroids in treating the assumed covid & didn't get vaccinated are leading normal life with life time immunity got by natural way. Thank you doctor Yogeesh D Kamat for all the information.

  • Daniel, Mangalore

    Tue, Sep 13 2022

    Doctor, Covid nothing but or more or less influenza but these elite and Communist chinese stopping common flu medication to push billions of Dollars money making injections (for their hidden agenda of world control by Incapacitating or decimating enemy military specially of US with mRNA shots) These spike protein generating injections as per Dr.Sucharit Bhakdi a renowned micro biologist cause blood clots, cell damages, So these clots lead to all sorts pains and problems ?

  • Dr Kusuma Kumari Gunji MBBS DGO, Nellore Kodyadka

    Tue, Sep 13 2022

    I had COVID and after that there was severe back pain but over the years I survived and improved. After reading your article I feel it might have been COVID infection . Anyway now I am better now. One of these days I would consult you regarding the pain

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