Cementless Total HIP Replacements in Sickle Cell Disease. Issue 2 (23rd March 2016)

• Record Type: Journal Article
• Authors: Jack, Christopher M.; Howard, Jo; Aziz, Emad S.; Kesse-Adu, Rachel; Bankes, Marcus J.
• Is Part Of: Hip international. Volume 26:Issue 2(2016)
• Page Start: 186
• Page End: 192
• Publication Date: 2016-03-23
• Subjects: Ceramic -- Hip arthroplasty -- Sickle; Hip joint -- Pathophysiology -- Periodicals; Hip joint -- Diseases -- Periodicals; Hip joint -- Surgery -- Periodicals; 617.581005
• DOI: 10.5301/hipint.5000317
• Languages: English
• ISSNs: 1120-7000

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.