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Total hip arthroplasty in sickle cell hemoglobinopathies
Gerard K Jeong1, David E Ruchelsman, Laith M Jazrawi
1Department of Orthopaedic Surgery, NYU-Hospital for Joint Diseases Orthopaedic Institute, New York, NY 10003, USA.
Summary
Patients with sickle cell hemoglobinopathies are increasingly undergoing total hip arthroplasty for osteonecrosis. Cementless hip arthroplasty offers encouraging outcomes for pain relief and function in selected patients.
Area of Science:
- Orthopedic Surgery
- Hematology
Background:
- Improved life expectancy in sickle cell hemoglobinopathies leads to more patients with osteonecrosis.
- Osteonecrosis is a common complication requiring total hip arthroplasty in this population.
Purpose of the Study:
- To review patient evaluation and surgical considerations for total hip arthroplasty in sickle cell patients.
- To discuss preoperative, intraoperative, and postoperative management strategies.
Main Methods:
- Review of current literature on total hip arthroplasty for sickle cell hemoglobinopathies.
- Analysis of patient selection, surgical techniques, and fixation methods.
Main Results:
- Multidisciplinary preoperative strategies improve surgical outcomes.
- Cementless total hip arthroplasty shows encouraging results for acetabular and femoral fixation.
- Careful intraoperative technique minimizes risks like perforation and loosening.
Conclusions:
- Total hip arthroplasty can significantly relieve pain and restore function in appropriately selected sickle cell patients.
- Despite increased risks, successful outcomes are achievable with careful management.