Study of functional outcome and complications of total hip replacement in avascular necrosis of femoral head due to sickle cell disease

• Author Details:   
• Sparsh Jain
• Pradeep Choudhari
• Sourabh Khande ^*

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Background:  Sickle cell disease (SCD) is an autosomal recessive genetic disorder marked by the production of abnormal sickle hemoglobin, which reduces red blood cell pliability. This results in vascular occlusion, leading to tissue ischemia and infarction. Bone involvement is a common manifestation, ranging from acute vaso-occlusive crises to chronic complications such as avascular necrosis (AVN). AVN of the femoral head frequently progresses to hip osteoarthritis, severely affecting joint function. Total hip replacement (THR) can significantly improve pain and mobility. This study evaluates the functional outcomes and complications of THR in patients with SCD.

Methodology: A total of 25 patients with SCD underwent THR. Functional outcomes were assessed using the Harris Hip Score (HHS) at 6-week, 3-month, and 6-month follow-ups.

Results: The mean age of patients was 26.80?±?9.35 years. The mean preoperative HHS was 58.25?±?4.32, which improved to 90.33?±?4.44 at 6 months postoperatively. At the 6-month follow-up, 15 patients (62.5%) showed excellent outcomes, 8 patients (33.3%) had good outcomes, and 1 patient (4.2%) had a fair result. Complications included limb length discrepancy in 3 patients (12%), dislocation in 2 patients (8%), superficial infection in 2 patients (8%), and 1 postoperative death (4%).

Conclusion: Total hip arthroplasty is an effective and reliable treatment for AVN of the hip secondary to sickle cell anemia. It significantly reduces pain, restores function, and enhances quality of life in affected patients.

Keywords: Sickle cell disease, Total hip arthroplasty, Avascular necrosis of femoral head.