[Hip dysplasia, a complication of sickle cell anemia]

Eighty-four hips of sickle cell anemia patients were followed up during adulthood after the occurrence during childhood of avascular necrosis of the femoral head. Roentgenograms showed residual dysplasia at completion of growth in a substantial number of cases: coxa magna was found in 11 hips, coxa plana or loss of capital sphericity in 53 hips, and true osteochondritis in 3 hips. Only 20 hips exhibited normal morphological features at completion of growth. Anomalies were found not only in the proximal femur but also in the acetabulum which was altered in 14 hips (inadequate lateral coverage in 8 hips and protrusion in 6). Roentgenological changes suggested that the acetabular alterations were due to triradiate cartilage lesions directly produced by the blood disorder rather than to the effects of the femoral alterations. The anomalies seen also suggested that the adverse effects of sickle cell anemia on growth involve not only epiphyseal ossification centers but also growth plates.