Clarke H J, Jinnah R H, Brooker A F, Michaelson J D
Johns Hopkins University, Baltimore, Maryland 21224.
J Bone Joint Surg Br. 1989 May;71(3):465-70. doi: 10.1302/0301-620X.71B3.2722941.
Total hip replacement was performed in 27 hips of patients who had sickle cell anaemia with avascular necrosis of the femoral head. The disease was bilateral in 11 patients. Considerable medical problems were encountered although most of the patients had exchange transfusion before surgery (86%), which prevented postoperative sickle cell crises in all but two cases. At the primary operation hard sclerotic bone was seen in nine femora with complete obliteration of the femoral canal. There were four femoral fractures, three following perforation of the shaft due to this hard bone. There was a very high morbidity due to loosening in both cemented and uncemented prostheses. With a rate of 59% over a cumulative 5.5 year period, revision was being performed at an average of only 43 months. Surgeons should be aware of these problems.
对患有镰状细胞性贫血且股骨头缺血性坏死的患者的27个髋关节进行了全髋关节置换术。11例患者为双侧患病。尽管大多数患者在手术前进行了换血治疗（86%），但仍遇到了相当多的医疗问题，除两例外，所有患者术后均未发生镰状细胞危象。在初次手术中，9个股骨可见坚硬的硬化骨，股管完全闭塞。发生了4例股骨骨折，其中3例是由于这种坚硬的骨头导致股骨干穿孔所致。骨水泥型和非骨水泥型假体均因松动导致很高的发病率。在累计5.5年的时间里，翻修率为59%，平均仅在43个月时就进行了翻修。外科医生应意识到这些问题。
