title: Results and complications of total hip arthroplasties in patients with sickle-cell hemoglobinopathies. Role of cementless components.
abstract: The complications and results of 16 primary and revision total hip arthroplasties in patients with sickle-cell hemoglobinopathies were evaluated. One patient died from renal failure at 1 year, leaving 15 hips in 10 patients for review at a mean follow-up period of 6 years (range, 2-12 years). There were 7 cementless primary total hip arthroplasties and 8 revision arthroplasties, 6 of which were uncemented. Patients were evaluated clinically using a standard hip rating system and radiographically using accepted criteria. There were no early or late deep infections; however, 7 of 8 primary arthroplasties and 5 of 8 revisions had one or more early complications. No cementless component demonstrated loosening; however, there was asymptomatic polyethylene wear in 2 primary arthroplasties, treated with grafting and liner exchange, and femoral osteolysis was present in 4 of 13 cementless arthroplasties, one of which was revised to permit extensive grafting. Of the original 15 arthroplasties performed by the senior author, 5 required some type of reoperation during the study. At most recent follow-up evaluation, no component in the study was radiographically loose. In the hips that did not require reoperation, the overall results were excellent in 6 hips, good in 3, and poor in 1 hip. Of the 5 hips requiring reoperation, the results were excellent in 3 hips, good in 1, and fair in 1 hip at most recent follow-up evaluation. Cementless components should be considered for all primary and revision arthroplasties in patients with sickle-cell hemoglobinopathies, but early complications are frequent and a high incidence of polyethylene wear and osteolysis requiring reoperation may be expected.
authors.affiliation: Department of Orthopaedics, University of North Carolina School of Medicine, Chapel Hill, USA.
authors.forename: J M
authors.initials: JM
authors.lastname: Hickman
authors.forename: P F
authors.initials: PF
authors.lastname: Lachiewicz
mesh_terms: D000328:Adult; D000755:Anemia, Sickle Cell / Q000150:complications*; D001843:Bone Cements; D005260:Female; D005271:Femur Head Necrosis / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery; D005500:Follow-Up Studies; D006622:Hip Prosthesis / Q000009:adverse effects / Q000379:methods; D006801:Humans; D016268:Internal Fixators; D007431:Intraoperative Complications; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D011183:Postoperative Complications; D011859:Radiography; D012086:Reoperation / Q000009:adverse effects; D012189:Retrospective Studies; D013997:Time Factors
chemical_list: D001843:Bone Cements