Long-term staged orthopedic reconstruction in a patient with sickle cell disease and complex multijoint fusion

Sickle cell disease is associated with numerous musculoskeletal complications, but joint ankylosis and congenital skeletal fusion are rarely reported. We present the case of a young woman with sickle cell disease and complex multijoint pathology, including hip ankylosis of uncertain etiology and congenital hindfoot fusion. Beginning in adolescence, she underwent staged orthopedic reconstruction over more than a decade, including bilateral total hip arthroplasty, lower-extremity deformity correction, arthrodesis, treatment of prosthetic joint infection, management of recurrent soft-tissue ulceration, and multiple hardware removals. Her clinical course was complicated by impaired wound healing, infection risk, and chronic pain requiring multidisciplinary management. Despite these challenges, staged surgical intervention resulted in meaningful functional improvement and improved ambulatory capacity. This case highlights the feasibility of complex, longitudinal orthopedic reconstruction in patients with sickle cell disease while emphasizing the elevated risks of infection, wound complications, and pain management challenges.