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Bipolar hip replacement in sickle cell disease

B K Sanjay1, P G Moreau

  • 1Department of Orthopaedic Surgery, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia.

International Orthopaedics
|January 1, 1996
PubMed
Summary

Uncemented bipolar hip replacements can improve hip function in sickle cell disease patients with avascular necrosis. However, careful patient selection is crucial due to a high risk of complications, including femoral splits.

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Area of Science:

  • Orthopedic Surgery
  • Hematology

Background:

  • Sickle cell disease frequently causes avascular necrosis of the femoral head.
  • Avascular necrosis significantly impairs hip function and quality of life.

Purpose of the Study:

  • To evaluate the outcomes of uncemented bipolar hip replacements in patients with sickle cell disease-related avascular necrosis of the femoral head.
  • To identify complications associated with this procedure in this patient population.

Main Methods:

  • Retrospective study of 26 patients undergoing uncemented bipolar hip replacement between 1987 and 1992.
  • Average follow-up of 4.6 years.
  • Assessment of Harris hip scores, bone cultures, and radiological findings.

Main Results:

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  • Significant improvement in average Harris hip score from 36 to 88 post-operatively.
  • Bacterial growth (coagulase-negative staphylococcus) in 4 hips.
  • Progressive acetabular cartilage wear in 2 cases; no femoral stem loosening.
  • 17 complications in 9 patients, with longitudinal femur split in 5 hips.
  • Femoral medullary sclerosis observed in 8 cases.

    • Conclusions:

    • Uncemented bipolar hip replacement can be a viable option for carefully selected sickle cell disease patients with avascular femoral head necrosis.
    • High complication rates necessitate thorough patient evaluation and risk assessment.
    • Longitudinal femur split is a notable operative complication in this cohort.