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Total hip arthroplasty in sickle cell hemoglobinopathy
M C Moran1, M H Huo, K L Garvin
1Hospital for Special Surgery, New York Hospital-Cornell University Medical Center, New York.
Clinical Orthopaedics and Related Research
|September 1, 1993
Summary
Total hip arthroplasty in sickle cell hemoglobinopathy (SCH) patients shows high failure rates. Aseptic loosening and sepsis are common complications, indicating significant risks despite potential benefits.
Area of Science:
- Orthopedic Surgery
- Hematology
- Reconstructive Surgery
Background:
- Sickle cell hemoglobinopathy (SCH) often leads to avascular necrosis and hip joint degeneration.
- Total hip arthroplasty (THA) is considered for managing severe hip complications in SCH patients.
Purpose of the Study:
- To evaluate the outcomes and complication rates of total hip arthroplasty in patients with sickle cell hemoglobinopathy.
- To identify factors associated with THA failure in this patient population.
Main Methods:
- Retrospective review of 22 total hip arthroplasties (15 primary, 7 revision) in 14 SCH patients.
- Analysis of follow-up data, implant survival, complication rates, and associated risk factors.
Main Results:
- High failure rates observed: 38% in primary and 43% in revision THA groups.
- Common failure modes included aseptic acetabular loosening (4 hips) and sepsis (2 hips).
- Perioperative complications were frequent, with intraoperative difficulties linked to bone changes in SCH.
Conclusions:
- Total hip arthroplasty in SCH patients carries a substantial risk of complications and failure.
- Bone alterations in SCH contribute to surgical challenges and reduced long-term component fixation.
- While THA offers a treatment option, careful patient selection and risk management are crucial.