Survival of total hip arthroplasty (THA) in sickle cell disease

BackgroundThe objective of this study was to evaluate the outcome of THA done in patients with sickle cell disease at a single center, and compare with rest of the world before we could recommend routine THA in SCD patients.MethodsIn 92 patients, 117 THAs were performed in sickle cell patients. Seventy-six (76) patients had homozygous hemoglobin (Hgb SS) disease, whereas sixteen had sickle cell trait (Hgb AS). Patients with Grade III Ficat and above avascular necrosis of the head of femur (ANFH) with cementless porous-coated proximal femur fixation were included in this analysis. Harris hip score was modified (MHHS) and used for assessment of improvement and visual analog scale score (VAS), for pain assessment.ResultVAS improved from average pre-operative mean of 7 (7-9) to 2.5 (1-5). The average pre-operative MHHS was 44 (32-63), and it improved to 79 (71-88) in the final mean follow-up of 12.4 (4-18) years. Nine patients (9.7%) had complications and revision surgery was required in seven (5.9%) for aseptic loosening.ConclusionOur analysis shows that THA in sickle cell disease is safe with average 12 years of follow-up, indicating that surgery in these young patients (& LE; 25 years) is safe and should not be delayed.