Osteonecrosis of the hip in the sickle-cell diseases. Treatment and complications

The results of arthroplasty of the hip and other surgical procedures that were performed in nine patients who had sickle-cell disease or sickle-cell trait and osteonecrosis of the femoral head were not very satisfactory. After an average duration of follow-up of 6.5 years (range, two to 25.7 years),...

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Bibliographic Details
Published inJournal of bone and joint surgery. American volume Vol. 70; no. 4; p. 499
Main Authors Hanker, G J, Amstutz, H C
Format Journal Article
LanguageEnglish
Published United States 01.04.1988
Subjects
Adult
Anemia, Sickle Cell - complications
Child
Female
Femur Head Necrosis - etiology
Femur Head Necrosis - surgery
Hip Joint - diagnostic imaging
Hip Joint - physiology
Hip Prosthesis
Humans
Male
Middle Aged
Movement
Pain
Prognosis
Prosthesis Failure
Radiography
Sickle Cell Trait - complications
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Summary:The results of arthroplasty of the hip and other surgical procedures that were performed in nine patients who had sickle-cell disease or sickle-cell trait and osteonecrosis of the femoral head were not very satisfactory. After an average duration of follow-up of 6.5 years (range, two to 25.7 years), the complications were many and severe. Of eight arthroplasties that were done for replacement of a joint, five required early revision or excision: two, because of mechanical loosening; two, because of sepsis; and one, due to a fracture of the prosthetic stem. There was excessive perioperative blood loss, prolonged hospitalization, and medical or surgical complications in all patients, including the three who had sickle-cell trait and only slight manifestations of systemic disease. A survivorship analysis of this series indicated that a failure rate of 50 per cent could be expected by 5.4 years postoperatively.
ISSN:0021-9355
1535-1386
DOI:10.2106/00004623-198870040-00004