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J Am Acad Orthop Surg, Vol 13, No 3, May/June 2005, 208-217.
© 2005 the American Academy of Orthopaedic Surgeons
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Total Hip Arthroplasty in Sickle Cell Hemoglobinopathies

Gerard K. Jeong, MD, David E. Ruchelsman, MD, Laith M. Jazrawi, MD and William L. Jaffe, MD

Dr. Jeong is Resident, Department of Orthopaedic Surgery, NYU–Hospital for Joint Diseases Orthopaedic Institute, New York, NY. Dr. Ruchelsman is Resident, Department of Orthopaedic Surgery, NYU–Hospital for Joint Diseases Orthopaedic Institute. Dr. Jazrawi is Assistant Professor, Department of Orthopaedic Surgery, NYU–Hospital for Joint Diseases Orthopaedic Institute. Dr. Jaffe is Vice Chairman and Clinical Professor, Department of Orthopaedic Surgery, NYU–Hospital for Joint Diseases Orthopaedic Institute.

Reprint requests: Dr. Jeong, Hospital for Joint Diseases Orthopaedic Institute, 14th Floor, 301 East 17th Street, New York, NY 10003.

Advances in medical treatment have led to improved life expectancy in patients with sickle cell hemoglobinopathies. Improved life expectancy has, in turn, led to an increasing number of patients with osteonecrosis requiring total hip arthroplasty. Patient evaluation begins with understanding the extent of the disease process and the patient’s musculoskeletal manifestations (ie, pyogenic infection, marrow hyperplasia, osteonecrosis). A multidisciplinary approach to implementing effective preoperative treatment strategies increases the likelihood of a successful surgical outcome. Intraoperatively, consideration of bone stock, bone quality, and method of component fixation may help minimize the risk of eccentric reaming, perforation or fracture of either the acetabulum or the femur, and loosening. The optimal mode of acetabular and femoral fixation in these patients has not been conclusively determined, but recent results of cementless total hip arthroplasty have been encouraging. Although patients with sickle cell disease are at increased risk of medical and surgical complications, total hip arthroplasty in the appropriately selected patient can provide significant pain relief, restoration of function, and patient satisfaction.




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M. A. Mont, L. C. Jones, and D. S. Hungerford
Nontraumatic Osteonecrosis of the Femoral Head: Ten Years Later
J. Bone Joint Surg. Am., May 1, 2006; 88(5): 1117 - 1132.
[Abstract] [Full Text] [PDF]


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