Kamath AF, McGraw MH, Israelite CL. Surgical management of osteonecrosis of the femoral head in patients with sickle cell disease. World J Orthop 2015; 6(10): 776-782 [PMID: 26601059 DOI: 10.5312/wjo.v6.i10.776]
Corresponding Author of This Article
Atul F Kamath, MD, Department of Orthopedic Surgery, the Center for Hip Preservation, Penn Medicine, University of Pennsylvania, 800 Spruce Street, 8th Floor Preston, Philadelphia, PA 19107, United States. akamath@post.harvard.edu
Research Domain of This Article
Orthopedics
Article-Type of This Article
Review
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Orthop. Nov 18, 2015; 6(10): 776-782 Published online Nov 18, 2015. doi: 10.5312/wjo.v6.i10.776
Surgical management of osteonecrosis of the femoral head in patients with sickle cell disease
Atul F Kamath, Michael H McGraw, Craig L Israelite
Atul F Kamath, Michael H McGraw, Craig L Israelite, Department of Orthopedic Surgery, the Center for Hip Preservation, Penn Medicine, University of Pennsylvania, Philadelphia, PA 19107, United States
Author contributions: Kamath AF, McGraw MH and Israelite CL solely contributed to this paper.
Conflict-of-interest statement: The authors have no conflicts of interest to disclose pertaining to the subject of this review manuscript.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Atul F Kamath, MD, Department of Orthopedic Surgery, the Center for Hip Preservation, Penn Medicine, University of Pennsylvania, 800 Spruce Street, 8th Floor Preston, Philadelphia, PA 19107, United States. akamath@post.harvard.edu
Telephone: +1-215-6878169 Fax: +1-215-8292492
Received: May 18, 2015 Peer-review started: May 18, 2015 First decision: August 6, 2015 Revised: August 28, 2015 Accepted: September 16, 2015 Article in press: September 18, 2015 Published online: November 18, 2015
Abstract
Sickle cell disease is a known risk factor for osteonecrosis of the hip. Necrosis within the femoral head may cause severe pain, functional limitations, and compromise quality of life in this patient population. Early stages of avascular necrosis of the hip may be managed surgically with core decompression with or without autologous bone grafting. Total hip arthroplasty is the mainstay of treatment of advanced stages of the disease in patients who have intractable pain and are medically fit to undergo the procedure. The management of hip pathology in sickle cell disease presents numerous medical and surgical challenges, and the careful perioperative management of patients is mandatory. Although there is an increased risk of medical and surgical complications in patients with sickle cell disease, total hip arthroplasty can provide substantial relief of pain and improvement of function in the appropriately selected patient.
Core tip: The management of hip pathology in sickle cell disease presents numerous medical and surgical challenges, and the careful perioperative management of patients is mandatory. Key aspects of medical optimization and surgical care are presented in this brief review.
