title: Cementless total hip replacements in sickle cell disease.
abstract: BACKGROUND
  Sickle cell disease (SCD) affects around 80,000 people in the USA and 12,000 in the UK. Up to 40% of patients will get osteonecrosis of the femoral head. Cemented acetabular components yield poor results with the rate of osteolysis ranging from 13.5 to 46%. We report on a consecutive cohort of patients with SCD who underwent uncemented THA with ceramic-on-ceramic (CoC) bearings.
  
  
  METHODS
  Since 2002 52 primary THAs were carried out in 40 patients. The average age was 36.1 years (17-54). 48 cases had exchange blood transfusion preoperatively and 3 had top-up transfusions.An S-ROM was used in 47 hips a Solutions stem in 4 hips and an AML in 1. It was necessary to drill the femur during 12 hips. There were 5 intra-operative peri-prosthetic fractures. 2 dislocations were observed. 2 superficial infections were detected.
  
  
  RESULTS
  All components have in-grown. There have been no cases of radiographic osteolysis, migration or loosening of the hip with average 5-year (2-10.1) follow-up.
  
  
  CONCLUSIONS
  The combination of a multidisciplinary team approach and uncemented implants, with ceramic-on-ceramic bearings used, has made THA in patients with SCD a safe and reliable procedure in our hospital.
authors.affiliation: University Hospital Southampton, Southampton, Hampshire - UK.
authors.forename: Christopher M
authors.initials: CM
authors.lastname: Jack
authors.affiliation: University Hospital Southampton, Southampton, Hampshire - UK.
authors.forename: Jo
authors.initials: J
authors.lastname: Howard
authors.affiliation: University Hospital Southampton, Southampton, Hampshire - UK.
authors.forename: Emad S
authors.initials: ES
authors.lastname: Aziz
authors.affiliation: University Hospital Southampton, Southampton, Hampshire - UK.
authors.forename: Rachel
authors.initials: R
authors.lastname: Kesse-Adu
authors.affiliation: University Hospital Southampton, Southampton, Hampshire - UK.
authors.forename: Marcus J
authors.initials: MJ
authors.lastname: Bankes
mesh_terms: D000293:Adolescent; D000328:Adult; D000755:Anemia, Sickle Cell / Q000150:complications* / Q000628:therapy; D019644:Arthroplasty, Replacement, Hip / Q000379:methods*; D001803:Blood Transfusion; D005260:Female; D005500:Follow-Up Studies; D006621:Hip Joint / Q000000981:diagnostic imaging / Q000601:surgery*; D006622:Hip Prosthesis; D006801:Humans; D015994:Incidence; D007592:Joint Diseases / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology*; D011300:Preoperative Care / Q000379:methods; D011474:Prosthesis Design; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology; D055815:Young Adult