[Total hip arthroplasty for the treatment of septic hip arthritis in adults with sickle-cell disease].
OBJECTIVE
Septic hip arthritis is a recognized complication of sickle-cell disease. The incidence is difficult to assess but is significant since certain authors estimate that 11% of children with sickle-cell disease develop orthopedic complications. We report our experience with hip joint infection in adults with sickle-cell disease.


METHODS
We diagnosed ten cases of hip joint infection in seven adults with sickle-cell disease. The characteristic feature of the septic arthritis was the development of a septic focus in a zone of osteonecrosis of the femoral head. Diagnosis was difficult due to the presence of prior hip disease and also the circumstances of development: other infectious foci, septicemia, distant osteomyelitis. The diagnosis was confirmed by joint puncture and isolation of the causal germ. Despite adapted antibiotics and immobilization with traction-suspension, hip joint destruction could not be prevented and all patients became bedridden. Surgery was therefore undertaken to remove the head and neck and institute local antibiotic treatment. A total hip prosthesis was implanted in all patients.


RESULTS
At 2 to 12 years follow-up, all seven patients had nearly normal hip function (all 10 hips). Recurrent infection nevertheless developed in 2 hips, demonstrating the limitations of this technique.
Hernigou
P
P
Service de Chirurgie Orthopédique, Hôpital Henri-Mondor, 51, avenue du Maréchal-de-Lattre-de-Tassigny, 94010 Créteil Cedex.
Odent
T
T
Manicom
O
O
Nogier
A
A
Bachir
D
D
Galacteros
F
F
D000328:Adult; D000755:Anemia, Sickle Cell / Q000150:complications*; D001170:Arthritis, Infectious / Q000150:complications* / Q000601:surgery*; D019644:Arthroplasty, Replacement, Hip; D005260:Female; D006621:Hip Joint; D006801:Humans; D008297:Male; D012189:Retrospective Studies