Abstract:
Avascular necrosis (AVN) of the femoral head results from impaired blood supply, a condition increas
ingly observed in post-COVID-19 patients due to virus-induced microvascular damage. Conventional therapies often fail
to address the vascular pathology. This retrospective cohort study, conducted from September 2020 to March 2024 in a
tertiary hospital in Uzbekistan, included 350 post-COVID AVN patients divided into two groups. The case group (n=190)
received standard conservative treatment plus hirudotherapy (2–3 times/week for 2 months), while the control group
(n=160) received standard conservative care alone. Outcomes were evaluated through MRI staging and SF‑36 scores at
baseline and every 6 months over 2 years. Results showed a significantly lower rate of femoral head collapse (10% vs.
34.4%), progression (20% vs. 51.3%), and surgery (3.2% vs. 10%) in the case group, with improved SF‑36 scores. This
multimodal therapy demonstrates potential as an effective, non-surgical option for managing early-stage post-COVID
AVN.
