Table 3.

Hip joint affection and management details

No	Author	Side	The time interval between COVID-19 diagnosis and hip AVN detection*	AVNFH stages (Classification)	Management	Outcomes
1	Agarwala et al. [19]	2 Bilateral, 1 left side only	58 ± 1.9 days (45–67)	Stage II in all hips (Ficat-Arlet)	Weekly oral alendronate (70 mg) and annual IV zoledronic acid (5 mg)	Mean VAS improved from 8 (6–9) to 2.7 (1–4) (no patient required surgery)
2	Sulewski et al. [15]	Unilateral	13.3 ± 0.5 days (7–22)	2 Stage IV, 1 stage II (Steinberg scale)	-1 Medical (NSAIDs, intra-articular steroid injections, joint aspiration) -2 THA	VAS improved from (7–8) to (0–2)
3	Yilmam et al. [29]	Bilateral	95 days	NR	Hyperbaric oxygen, and physiotherapy‡	NR
4	Agarwala et al. [18]	NR	179 days (59–459)	13 Stage I, 66 stage II, 9 stage III (Ficat-Arlet)	Intravenous zoledronic acid (ZA) injection (5 mg) at the initiation of therapy + oral alendronate (35 mg) twice a week along + calcium (1,000 mg) + vitamin D3 (800 IU) daily, and Partial weight-bearing for the first 3 months	-At six months, VAS improved from 7.03 at presentation to 3.13, and HHS improved from 59.14 at presentation to 71.01 -95.5% of the hips had good clinical outcomes and did not require any surgical intervention
5	Annam et al. [20]	Bilateral	6.5 months (4–9)	1 stage I, 2 stage II, 1 stage IV (Ficat-Arlet)	2 Core decompression & 2 THA	NR
6	Ardakani et al. [21]	3 Bilateral, 1 right side, 1 left side	41.6 ± 1.4 days (29–56)	Reported 4 hips, 2 Stage IV, 2 stage II (Ficat-Arlet)§	-Hip aspiration was performed for all hips to exclude infection -Aspiration and irrigation for 2 hips -1st stage THA only in three hips -staged THA in three hips	Mean VAS improved from 9.4 to 2.8
7	Dhanasekararaja et al. [22]	17 Bilateral, 2 right side, 3 left side	7.5 months (3–11)	32 Stage II, 7 stage III (Ficat-Arlet)	-All the patients underwent initial conservative therapy with bisphosphonates, calcium and non-steroidal anti-inflammatory agents -3 hips diagnosed with Rapidly destructive coxarthrosis underwent THA	Improved HHS ( from 63.6 ± 23.2 at presentation to 82.6 ± 9.6 after treatment)
8	Etta et al. [30]	Bilateral	63 days	NR	Core decompression with bone grafting and physiotherapy	NR
9	Jain and Sawant [23]	Bilateral	25 days	Stage IV (Ficat-Arlet)**	Staged THA	Full painless range of motion of both hips with no clinical signs of active infection
10	Kamani et al. [24]	Bilateral	NR	STAGE IV and II (Ficat-Arlet)	Core decompression and physiotherapy	The numerical Pain Rating Scale (NPRS) improved from 8/10 to 2/10
11	Kandari et al. [25]	5 Bilateral, 6 unilateral	7 months	1 Stage I, 8 stage II, 5 stage III, 2 stage IV (Ficat-Arlet)	2 THA, 1 core decompression, 13 conservative (bisphosphonates and protected weight bearing)	-Mean VAS improved from 7.19 ± 0.91 to 2.69 ± 1.16 -Mean HHS improved from 59.25 ± 6.92 to 77.75 ± 5.91
12	Kinjima et al. [26]	Bilateral	10 months	Stage IV (Ficat-Arlet)	THA	NR
13	Maharjan et al. [27]	Bilateral	7 months	Stage I and stage III (Ficat-Arlet)	Core decompression, BMAC injection, physiotherapy, and bisphosphonates (alendronate 70 mg OD weekly for 2 months)	Clinical improvement was reported (no scores reported); patient was mobilizing without crutches
14	Mahran et al. [28]	3 Bilateral, 1 left side	10.3 months (7–12)	5 Stage II, 2 stage III (Steinberg scale)	Core decompression (with only one later conversion to THA)	NR

^‡The authors mentioned that this line of management was planned for the Patient; however, they did not report if the Patient had it or not

^§Concomitant infection was reported in 6 hips (2 non-typhoid salmonellae, 2 Serratia marcescens, and 2 coagulase-positive staphylococci)

**Concomitant infection in both hips (multidrug-resistant Escherichia coli)

*Mean ± SD (range)

-Staged THA: this means that the Patient had a cement spacer loaded with antibiotics as a first stage, then the second stage was definitive THA

AVNFH avascular necrosis of the femoral head, NR not reported, THA total hip arthroplasty, VAS visual analog scale, HHS Harris hip score