Published online Nov 18, 2015. doi: 10.5312/wjo.v6.i10.776
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
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.