Unapproved Weight Gain Supplement as a Cause of Avascular Necrosis: A Cautionary Report

Avascular necrosis of the femoral head (AVNFH) is a leading cause of end-stage joint disease in the young populationthat can lead to total hip replacement in early life. There are various risk factors, including trauma, corticosteroids,thrombosis, hypertension, and alcohol. There is a growing number of patients with AVNFH and history of self-medicationwith herbal supplement used for weight gain in Iran. The present study aimed to demonstrate the prevalence rate ofusing unapproved weight gain supplements (UWGS) in patients with AVNFH.An observational and cross-sectional study was conducted to estimate the prevalence rate of using UWGSs in patientswith osteonecrosis at Imam Khomeini Hospital, Tehran, Iran, from January 2012 to 2018. The data were analyzed inSPSS software (version 24) through descriptive statistics and tests of means.Out of 207 patients with AVNFH, 115 cases were male. In total, 44 patients (20.95%) had a history of using UWGSs,and there had no other risk factors of osteonecrosis of FH.In conclusion, UWGSs can be a risk factor for AVNFH, and it is necessary to develop educational programs to alertyoung population about the side effects of these supplements.Level of evidence: III