Abstract
Osteonecrosis of femoral head is well known and recognised complication in Sickle cell disease patients. Due to the severity of the Osteonecrosis, hip pain is major limiting factor for these patients requiring total hip arthroplasty in relatively young age. We studied and report our results in total hip arthroplasty of sickle cell patients.
We studied 80 patients from our combined Orthopaedic & Haematology Sickle cell clinic. Twenty four patients had painful Osteonecrosis with secondary osteoarthritis of hip and underwent total hip arthroplasty. Three patients had bilateral hip replacements. A total of twenty seven replacements were studied retrospectively. 19 patients had uncemented (Corail/Pinnacle), 5 patients had hybrid(Pinnacle/Exeter) and 3 patients had cemented(Exeter) total hip arthroplasties respectively.
The patients were serially followed up for clinical and radiological assessments for loosening. Oxford hip score (OHS) was used to assess the functional outcome. The average age of the patients at the time of surgery was 38.4 (Range – 20 to 59 years. The average follow up was 5.1 years (Range – 6 months to 10 years). There were 13 female and 11 male patients. The average oxford hip score was 38.07 with 10% infection rate and 11% aseptic loosening.
Arthroplasties carry high risk in patients with sickle cell disease. We report lower rates of infection and loosening rates compared to the earlier studies. Combined Haematological and Orthopaedic team input is optimal during assessment, surgery, peri-operative period and follow up. Our results of total hip replacements in sickle cell disease patients are good.
