Staged Bilateral Uncemented Total Hip Arthroplasty for Steroid-Induced Avascular Necrosis of the Femoral Head in a Young Woman

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Case Report

PAH Med Col J. Jul 2026; 3(2): 66-73

Abstract

Background: Avascular necrosis (AVN) of the femoral head is a progressive and disabling condition that predominantly affects young adults. Prolonged corticosteroid exposure is a well-established risk factor, while unsupervised steroid use remains a concern in resource-limited settings.

Case Summary: A 19-year-old woman from a low-income rural background in Bangladesh presented with bilateral hip pain for three years and progressive difficulty walking, after taking oral corticosteroids for about four years on the advice of an unqualified practitioner. Pelvic radiographs demonstrated bilateral joint-space narrowing consistent with advanced AVN. Staged uncemented modular total hip arthroplasty was performed, with the left hip replaced first and the right hip approximately ten months later.

Results: At follow-up, the patient was walking comfortably with satisfactory function of both hip replacements.

Conclusion: Unregulated and prolonged corticosteroid use can lead to severe bilateral AVN even in very young patients. Staged total hip arthroplasty can provide satisfactory functional recovery in young patients with end-stage bilateral AVN.

Keywords

Avascular necrosis, Femoral head, Corticosteroids, Total hip arthroplasty, Young adult, Case report


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How to cite: Bhadra A, Rahaman A, Rouf MA, Fahim MI. Staged Bilateral Uncemented Total Hip Arthroplasty for Steroid-Induced Avascular Necrosis of the Femoral Head in a Young Woman. PAH Med Col J. Jul 2026; 3(2): 66-73.

DOI: https://doi.org/10.70945/pahmc.v03i02.05