Cementless total hip replacements in sickle cell disease.

Area of Science:

• Orthopedic Surgery
• Biomaterials Science
• Hematology

Background:

• Sickle cell disease (SCD) impacts numerous individuals, with a high incidence of femoral head osteonecrosis.
• Cemented acetabular components demonstrate suboptimal outcomes in SCD patients, marked by significant osteolysis rates.
• Uncemented total hip arthroplasty (THA) with ceramic-on-ceramic (CoC) bearings presents an alternative approach.

Purpose of the Study:

• To evaluate the efficacy and safety of uncemented THA using CoC bearings in patients with SCD.
• To assess the long-term outcomes, including osteolysis, migration, and loosening, of these implants.

Main Methods:

• A cohort of 40 SCD patients underwent 52 primary THAs between 2002 and the present.
• Preoperative blood transfusions were administered to most patients.
• Uncemented implants (S-ROM, Solutions, AML) were utilized, with some cases requiring femoral drilling.

Main Results:

• All uncemented components achieved osseointegration.
• No instances of radiographic osteolysis, migration, or loosening were observed.
• The average follow-up period was 5 years, ranging from 2 to 10.1 years.

Conclusions:

• Uncemented THA with CoC bearings is a safe and effective procedure for SCD patients.
• A multidisciplinary team approach is crucial for successful outcomes.
• This approach minimizes complications like osteolysis and implant failure.