BIPOLAR HIP-REPLACEMENT IN SICKLE-CELL DISEASE

A retrospective study is presented of 26 uncemented bipolar hip replac ements for avascular necrosis of the femoral head due to sickle cell d isease which were carried out between 1987 and 1992. All patients were treated according to a protocol. The average follow up was 4.6 years (range 2.1 to 7 years). After operation, the average Harris hip score improved from 36 to 88. Bone culture was positive for bacterial growth in 4 hips (coagulase negative staphylococcus in 3). There was progres sive wear of acetabular articular cartilage in 2 cases, but no clinica l or radiological evidence of loosening of the femoral stem. Seventeen complications occurred in 9 of the 21 patients (5 in one patient). A longitudinal split of the femur was the commonest operative complicati on and occurred in 5 hips. Femoral medullary sclerosis was seen in 8 c ases. Patients with sickle cell disease have a high risk of complicati ons, but this type of hip replacement should be considered in carefull y selected patients who have avascular necrosis of the femoral head.