40% rise in hip replacements among post-Covid patients in their 30s and 40s

A new post-pandemic health concern is slowly emerging in India, and orthopaedic experts say it is affecting people much younger than expected. Doctors are now witnessing a sharp rise in cases of hip arthritis and avascular necrosis (AVN), a painful condition caused by reduced blood supply to the hip bone.

What is especially worrying is that many patients are in their 30s and 40s, age groups that traditionally were not considered at high risk for severe hip damage.

The issue was highlighted at the 2nd DELHI HIP 360 Conference held in New Delhi, where leading orthopaedic surgeons and joint replacement specialists discussed the growing number of young adults requiring Total Hip Replacement (THR) surgeries after recovering from COVID-19.

Experts believe that prolonged or excessive use of steroids during COVID treatment may have played a major role in triggering these complications in some patients.

DOCTORS REPORT A 40% RISE IN HIP REPLACEMENT SURGERIES

Doctors say the problem often develops silently. Many people initially ignore symptoms such as mild groin pain, stiffness, limping, or discomfort while walking, assuming it is due to muscle strain or fatigue.

However, in AVN, the bone tissue begins to die because of poor blood supply. Over time, this can cause the hip joint to collapse completely, making surgery the only option left to restore mobility.

According to experts speaking at the conference, hospitals are now seeing a nearly 40 per cent rise in hip replacement surgeries among younger individuals compared to pre-pandemic years. This increase has raised concerns among doctors, especially because these patients may have to live with the effects of joint damage for decades.

Dr L Tomar, Organising Chairman of DELHI HIP 360 and Director of Orthopaedics and Joint Replacement at Max Hospital, Delhi, said steroids were important and life-saving during the pandemic, but indiscriminate use may have long-term consequences.

“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,” he explained.

He further added that many younger patients are now coming to hospitals with severe damage to the hip bone, collapse of the femoral head, and advanced arthritis that requires early hip replacement surgery.

WHAT IS AVASCULAR NECROSIS (AVN)?

Medical experts explained that avascular necrosis was once commonly seen in older adults, trauma patients, or people with chronic illnesses. However, after COVID, the disease pattern appears to be changing rapidly. Several international studies have also suggested a connection between high-dose steroid use during COVID-19 treatment and osteonecrosis of the femoral head, especially in people who already had metabolic or vascular risk factors.

Doctors stressed that early diagnosis can make a huge difference. If AVN is detected in the beginning stages, doctors may still be able to save the joint through non-surgical or joint-preserving procedures. However, once the bone collapses, total hip replacement often becomes unavoidable.

COVID STEROID USE AND SEDENTARY LIFESTYLE WORSENED THE PROBLEM

Dr Ashwani Maichand, Director of Orthopaedics, CK Birla Hospital, Delhi, said that avascular necrosis (AVN) is emerging as one of the biggest reasons behind the sudden increase in hip replacement surgeries among younger adults after Covid-19.

“One of the main reasons for this trend is avascular necrosis (AVN). This condition occurs when reduced blood flow causes bone tissue in the hip joint to die. Excessive or long-term steroid use during COVID-19 treatment, especially during the second wave, is thought to have greatly contributed to this issue,” he explained.

Dr Maichand added that many patients started experiencing continuous hip pain, limping, stiffness, and difficulty walking several months after recovering from COVID-19.

He also pointed out that lifestyle changes during the lockdown years worsened joint health in younger people.

“Sedentary lifestyles during lockdowns, weight gain, lack of physical activity, and delays in seeking medical help have also led to worsening joint health among younger people. Many patients now require total hip replacements nearly a decade earlier than expected,” he said.

WHY EARLY DIAGNOSIS IS IMPORTANT

The orthopaedic expert stressed that persistent hip or groin pain after COVID recovery should not be ignored.

“Ongoing hip or groin pain after recovering from COVID should never be neglected. Early diagnosis through MRI scans and timely medical treatment can help slow the progression of the disease and, in some cases, avoid surgery. Maintaining a healthy weight, regular exercise, and avoiding self-medication with steroids are important for long-term bone and joint health,” Dr Maichand added.

Dr Karun Jain, senior orthopaedic surgeon at Pushpanjali Medical Centre, said delayed diagnosis remains one of the biggest challenges.

“One of the biggest problems is that patients ignore early warning signs such as groin pain or stiffness. By the time they consult a doctor, the damage may already be irreversible,” he said.

Experts advised people recovering from COVID not to ignore persistent hip pain, difficulty in walking, stiffness, or limping, especially if they had received steroid treatment during their illness. They recommended early MRI scans and timely orthopaedic consultations to detect the condition before serious damage occurs.

ADVANCED HIP REPLACEMENT SURGERIES IMPROVING RECOVERY

The conference also focused on the latest developments in hip replacement surgeries, including robotic-assisted procedures, minimally invasive techniques, faster rehabilitation methods, and advanced implant technology. Surgeons said these innovations are helping patients recover more quickly and return to daily life sooner than before.

Dr Gaurav Govil, Associate Director of Orthopaedics and Joint Replacement at Max Hospital Patparganj, said Total Hip Replacement remains one of the most successful procedures in modern orthopaedics.

“With better implants, advanced surgical planning, and improved rehabilitation techniques, patients today are recovering faster and regaining mobility earlier. However, awareness and early treatment remain extremely important,” he said.

EXPERTS STRESS RESPONSIBLE STEROID USE AND AWARENESS

Experts at the conference warned that India could witness a major rise in hip replacement surgeries in the coming years if preventive orthopaedic care and early screening are not strengthened. They also stressed the need for responsible steroid use, better public awareness, and timely medical attention to prevent avoidable disability in younger populations.

Doctors say the key message is simple: persistent hip pain after COVID recovery should never be ignored. Early diagnosis could help save the joint and prevent long-term complications.