Osteonecrosis of the hip in the sickle-cell diseases. Treatment and complications.
The results of arthroplasty of the hip and other surgical procedures that were performed in nine patients who had sickle-cell disease or sickle-cell trait and osteonecrosis of the femoral head were not very satisfactory. After an average duration of follow-up of 6.5 years (range, two to 25.7 years), the complications were many and severe. Of eight arthroplasties that were done for replacement of a joint, five required early revision or excision: two, because of mechanical loosening; two, because of sepsis; and one, due to a fracture of the prosthetic stem. There was excessive perioperative blood loss, prolonged hospitalization, and medical or surgical complications in all patients, including the three who had sickle-cell trait and only slight manifestations of systemic disease. A survivorship analysis of this series indicated that a failure rate of 50 per cent could be expected by 5.4 years postoperatively.
Hanker
G J
GJ
Southern California Orthopedic and Sports Medical Group, Van Nuys 91405-3641.
Amstutz
H C
HC
D000328:Adult; D000755:Anemia, Sickle Cell / Q000150:complications*; D002648:Child; D005260:Female; D005271:Femur Head Necrosis / Q000209:etiology* / Q000601:surgery; D006621:Hip Joint / Q000000981:diagnostic imaging / Q000502:physiology; D006622:Hip Prosthesis; D006801:Humans; D008297:Male; D008875:Middle Aged; D009068:Movement; D010146:Pain; D011379:Prognosis; D011475:Prosthesis Failure; D011859:Radiography; D012805:Sickle Cell Trait / Q000150:complications*