Can Short Courses of Prednisone Cause Osteonecrosis of the Hip?

Osteonecrosis is a rare but recognized complication of corticosteroid therapy. It has been most well documented in patients who received high doses of steroids for longer than 3 months. These orthopedic surgeons reviewed the histories of patients who presented with osteonecrosis at a tertiary referral center in Canada from 1986 to 1996.

The authors identified 15 patients who had had a single short course of corticosteroids in the 3 years before presenting to the orthopedic unit. They found potentially confounding risk factors in 3 patients but considered none to be relevant contributors. All the patients were male, with a mean age of 32 years. The mean cumulative steroid dose was the equivalent of 850 mg of prednisone, given for a mean durat…