Total Hip Arthroplasty in Sickle-Cell Disease: Comparing Cemented and Non-Cemented Options

Abstract

Background: Avascular Necrosis of the Femoral Head (ANFH) is a well-known sequela of Sickle-Cell Disease (SCD), mostly requires Total Hip Arthroplasty (THA) as a salvage procedure for improving the quality of life of the patients. The present study was undertaken to analyze the outcome of cemented versus non cemented total hip arthroplasty in patients with SCD. Methods: From 2007 to 2015 total hip arthroplasty for disabling consequences of ANFH due to SCD hips was carried out for 106 in 70 patients. 36 patients had bilateral ANFH and 34 patients had unilateral disease of hip due to ANFH. Randomization was done blindly for cemented and non-cemented groups with 53 hips in each group. Average duration of follow-up ranged from 4 to 8 years. Results: The cemented and cement less group both were same as far as the Harris hip score, Quality of life improvement and hip movements were considered. One intra- operative fractures of the proximal femur and 4 superficial infections were observed in both the groups while 2 deep infections only in cement less group (3.77%), No aseptic shell failure in both groups and 1 aseptic femoral stem failure in cement less group (1.88%). There was no heterotopic ossification developed in current study. All the patients had uneventful postoperative period with no deaths resulting from the operative event. Conclusion: Whether cemented or non cemented, total hip arthroplasty is a reliable and safe procedure to improve quality of life in Sickle Cell Disease (SCD) with disabling effects due to hip pain. Cementless and cemented components both are associated with good long term results.