Total Hip Arthroplasty in Patient with Sickled Cell Trait Ss: The Cases of 14 Patients

Abstract

Osteo-articular complications of sickle cell disease are multiple but mostly dominated by epiphyseal aseptic necrosis.Conservative at the beginning, the surgical treatment becomes radical in the last stage with the performance of a total hip arthroplasty (THA). We report the case of total hip arthroplastyin a patient with sickle cell traitSSat Ordre de Malte Hospital (CHOM) in Dakar, focusing on the peri-operative complications encountered in this particular case in order to prevent them or to treat them if necessary. This is a retrospective, mono-centric study including 15 total hip arthroplasty (THA) performed in 14 SS sickle cell patients over a 66-month period. The postero-lateral Moore mini open approach was used exclusively. The clinical evaluation was based on the Aubigné Postel-Merle (PMA) and Harris (HHS) scores and the radiographic score on the Ficat and Arlet classification. The corticodiaphyseal index as well as the Noble flare index channel made it possible to appreciate the medullary congestion and the shape of the femur.All together, THA in Sickle Cell Disease represented 7.57% of all hip prosthetic activity during the period. The average age of patients (10 women and 4 men) was 29.06 years (18-50). The overall functional result was good and very good in 77% of cases. We observed 4 femoral fissures, an early vesicular lithiasis infection with psoas syndrome and acetabular loosening in the same patient and one death at 5 days postoperatively.