TOTAL HIP-ARTHROPLASTY IN SICKLE-CELL HEMOGLOBINOPATHY

Twenty-two arthroplasties were performed in 14 patients with sickle ce ll hemoglobinopathy (SCH). There were 15 primary and seven revision pr ocedures, none were lost to follow-up evaluation. In the primary artho plasty group, there were two deaths in patients whose implants were fu nctioning well. The remaining 13 hips had a mean follow-up period of 4 .8 years. Failure occurred in five of these 13 hips (38%), four due to aseptic acetabular loosening and one due to sepsis. In the revision a rthroplasty group, at a mean follow-up period of 5.3 years, failure oc curred in three hips (43%), one due to acetabular loosening, one due t o femoral loosening, and one due to sepsis. Perioperative complication rates were high in both groups. Femoral intramedullary sclerosis and bone altered by marrow hyperplasia were associated with intraoperative technical difficulties as well as problems with achieving long-term c omponent fixation. Though total hip arthroplasty provides the most rel iable measure of effective treatment in SCH, it carries a high risk of complications and failure.