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Total hip arthroplasty in osteonecrosis secondary to sickle cell disease

Mohamed Zubair Farook1, Moji Awogbade2, Karthik Somasundaram3

  • 1Department of Trauma & Orthopaedics, King's College Hospital NHS Foundation Trust, King's College London, Denmark Hill, London, SE5 9RS, UK.

International Orthopaedics
|June 17, 2018
PubMed

Insights

Total hip arthroplasty (THA) in sickle cell disease (SCD) patients showed comparable revision rates to general populations. Multidisciplinary care in a specialized sickle cell clinic effectively reduced complications, improving outcomes for these complex cases.

Area of Science:

  • Orthopedic Surgery
  • Hematology
  • Rheumatology

Background:

  • Sickle cell disease (SCD) frequently leads to osteonecrosis (ON), a significant cause of joint damage.
  • Total hip arthroplasty (THA) in SCD patients presents unique surgical challenges and higher complication risks.

Purpose of the Study:

  • To evaluate the outcomes of total hip arthroplasty (THA) in patients with sickle cell disease (SCD).
  • To analyze complication rates and identify factors influencing revision surgery in this cohort.

Main Methods:

  • Retrospective analysis of 34 THAs performed between 1999 and 2016 in 30 SCD patients.
  • Documentation of comorbidities, surgical procedures, and follow-up data, including complications and revision indications.

Main Results:

  • The study included 34 THAs in 30 patients (mean age 37 years) with a mean follow-up of 10.5 years.
  • Six patients (17.6%) required revision surgery: 2 for prosthetic joint infection (PJI) and 4 for acetabular osteolysis.
  • Revision rates were comparable to published literature for non-SCD populations.

Conclusions:

  • THA in SCD patients can achieve outcomes comparable to the general population.
  • A coordinated, multidisciplinary approach through a combined sickle cell clinic is effective in minimizing morbidity associated with THA in SCD.
Abstract

Keywords:
OsteonecrosisRevisionSickle cell diseaseTHA

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