Orthopedic Consequences of Post-COVID-19 High-dose Corticosteroid Use and Vaccination: An Update Study

Objectives: To update top-cited articles on the complications of high-dose corticosteroid use and vaccination-related avascular osteonecrosis after COVID-19.
Methods: Obtaining top-cited articles on the theme of 'COVID-19 avascular necrosis' from Web of Science and determining the evidence levels according to the complication topics of these trending topic articles, along with the evaluation of Altmetric Attention Score (AAS) and Dimensions badges via ‘Altmetric it’, to determine correlation analysis between publication metrics.
Results: Trending topic articles on early orthopedic complications of post-COVID-19-related high-dose steroid use have increased since 2020 and especially peaked in 2022. It is also noteworthy that the mesotopic is orthopedics and the microtopic is coronavirus. Besides, the complication most frequently mentioned in trending topic articles is femoral head avascular necrosis, and the majority of articles have evidence level 3 by SIGN100. The distribution range of AAS was especially large, while the total citation number (4.1±8.2) and average citation per year (1.6±2.7) were also slightly low. Moderately positive, statistically significant correlations were detected between the AAS, average citation per year, and total citation number (p<0.05).
Conclusion: The most common osteonecrosis associated with post-COVID-19 high-dose corticosteroid use is unilateral femoral head avascular necrosis, and care should be taken in treatment.