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9 Knee arthroplasties for sickle cell disease
A Shah1, A Mukherjee, P G Moreau
1Department of Orthopedics, King Faisal Specialist Hospital and Research Centre, Kingdom of Saudi Arabia.
Acta Orthopaedica Scandinavica
|April 1, 1993
Summary
Sickle cell disease patients undergoing knee replacement may have infected osteonecrosis. Cultures confirmed organisms in most cases, suggesting infection should be suspected in these cases.
Area of Science:
- Orthopedic Surgery
- Rheumatology
- Infectious Diseases
Background:
- Sickle cell disease frequently causes osteonecrosis, leading to knee joint problems.
- Knee arthropathy is a recognized complication of sickle cell disease, often linked to osteonecrosis.
Purpose of the Study:
- To evaluate the outcomes of total knee arthroplasty in patients with sickle cell disease-related osteonecrosis.
- To investigate the potential for infection in osteonecrosis associated with sickle cell disease.
Main Methods:
- Conducted 9 total knee arthroplasties in 5 patients with sickle cell disease.
- Collected joint fluid, synovium, capsule, and bone samples for microbiological cultures.
- Assessed patient outcomes using a standardized grading system.
Main Results:
- Tissue cultures from 5 knees (55.5%) yielded positive organism growth.
- Functional outcomes included 6 excellent, 1 good, 1 satisfactory, and 1 poor result.
- One patient experienced prosthesis removal due to infection, followed by arthrodesis.
- One patient developed persistent peroneal nerve palsy; no hematological complications occurred.
Conclusions:
- Osteonecrosis in sickle cell disease patients should be considered potentially septic.
- Infection is a significant concern in knee arthroplasty for sickle cell disease patients.
- Prompt diagnosis and management of infection are crucial for favorable outcomes.