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. 2019 Feb;43(2):293-298.
doi: 10.1007/s00264-018-4001-0. Epub 2018 Jun 15.

Total hip arthroplasty in osteonecrosis secondary to sickle cell disease

Mohamed Zubair Farook  1 , Moji Awogbade  2 , Karthik Somasundaram  3 , Ines L H Reichert  4 , Patrick L S Li  1
Affiliations

Total hip arthroplasty in osteonecrosis secondary to sickle cell disease

Mohamed Zubair Farook et al. Int Orthop. 2019 Feb.

Abstract

Background: Sickle cell disease (SCD) is a multisystem disease, and the predominant articular manifestation is osteonecrosis (ON). Total hip arthroplasty (THA) is technically challenging, and the complication rates are high. In this retrospective study, we have analysed the outcome of THA in a cohort of patients with SCD at our institution.

Materials and methods: We identified 34 THAs between 1999 and 2016 in 30 patients (mean age 37 years) from our SCD database. Co-morbidities, both sickle and non-sickle-related, were documented. Complications and indications for revision surgery were analysed.

Results: An uncemented prosthesis was predominantly used. The mean follow-up was 10.5 years (range 1-18). Six patients had revision surgery (17.6%), 2 (5.8%) for Prosthetic Joint Infection (PJI), and 4 (11.7%) for osteolysis of the acetabular component.

Conclusion: Our revision rates were comparable to the published literature. Our combined sickle cell clinic and the coordinated multidisciplinary management have been successful in reducing morbidity.

Keywords: Osteonecrosis; Revision; Sickle cell disease; THA.

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Conflict of interest statement

The authors declare that there is no conflict of interest.

Figures

Fig. 1
Fig. 1
a Steinberg Stage VI Osteonecrosis left hip with severe femoral canal Stenosis and stage III right hip. b Radiographs 8 years postoperatively showing well-integrated Stryker ABG uncemented components
Fig. 2
Fig. 2
Pre-operative radiographs of a 48-year-old male, with Steinberg stage VI osteonecrosis right hip with “femur within femur” appearance
Fig. 3
Fig. 3
a One-year post-operative radiographs of a 45-year-old female with a cemented Exeter THA and pre-operative left side with Steinberg stage 5 ON. b Fifteen-year post-operative radiographs right side with minimal eccentric polyethylene wear and 14-year post-operative left uncemented THA
See this image and copyright information in PMC

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