Ugbeye M E, Lawal W, Ayodabo O, Dim E M, Adegoke S
Arthroplasty Division, Department of Orthopaedics and Trauma Surgery, National Orthopaedic Hospital, Igbobi, Lagos, Nigeria.
Department of Orthopaedics and Traumatology, Faculty of Clinical Sciences, University of Uyo/University of Uyo Teaching Hospital, Uyo, Nigeria.
Niger J Clin Pract. 2020 Oct;23(10):1426-1430. doi: 10.4103/njcp.njcp_402_19.
Osteoarthritis secondary to osteonecrosis of the femoral head is a common presentation in patients with sickle cell disease. Functional limitations with or without deformities from these complications of sickle cell disease often require Total Hip Arthroplasty (THA) to improve outcome.
The aim of this study was to evaluate the postoperative outcome of THA for secondary osteoarthritis from osteonecrosis of the head of the femur in patients with sickle cell disease. Methodology: A retrospective study of outcome of THA in sickle cell disease patients between January 2010 and December 2015 is presented. Primary outcome was measured using the rates of complications and the Harris Hip scores at 6 weeks, 12 weeks, 6 months, and yearly.
A total of 68 THA in 56 patients with sickle cell disease was reviewed. The age range was 13-68 years, with a mean of 30.9 years. There were 15 males and 41 females (M: F ratio = 1:3). Approaches to the hip were direct lateral (64.3%), anterolateral (1.8%), and posterior (33.9%). 12 (21.4%) patients had bilateral total hip arthroplasty, and 44 (78.6%) had unilateral total hip arthroplasty. No patient required adductor tenotomy. Superficial surgical site infection was recorded in 7 (12.5%) patients. The postoperative functional outcome, measured by the Harris Hip score, was good or excellent in all patients, except 2 (2.9%) who required revision surgery following unacceptable results after primary hip arthroplasty.
THA is a viable and effective treatment modality for sickle cell disease patients with osteonecrosis and secondary hip osteoarthritis. The choice of surgical approach does not affect the outcome.
继发于股骨头坏死的骨关节炎是镰状细胞病患者的常见表现。镰状细胞病这些并发症导致的功能受限，无论有无畸形，通常都需要进行全髋关节置换术（THA）以改善预后。
本研究的目的是评估镰状细胞病患者因股骨头坏死继发骨关节炎行THA后的术后疗效。方法：对2010年1月至2015年12月期间镰状细胞病患者行THA的疗效进行回顾性研究。主要疗效指标采用并发症发生率以及术后6周、12周、6个月和每年的Harris髋关节评分。
共回顾了56例镰状细胞病患者的68例THA。年龄范围为13 - 68岁，平均年龄30.9岁。男性15例，女性41例（男：女比例 = 1:3）。髋关节手术入路为直接外侧入路（64.3%）、前外侧入路（1.8%）和后入路（33.9%）。12例（21.4%）患者行双侧全髋关节置换术，44例（78.6%）患者行单侧全髋关节置换术。无患者需要内收肌切断术。7例（12.5%）患者发生浅表手术部位感染。除2例（2.9%）患者在初次髋关节置换术后结果不理想需要翻修手术外，所有患者通过Harris髋关节评分测量的术后功能结局均为良好或优秀。
THA是治疗镰状细胞病合并骨坏死和继发性髋骨关节炎患者的一种可行且有效的治疗方式。手术入路的选择不影响疗效。
