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Journal of Long-Term Effects of Medical Implants

ISSN Print: 1050-6934
ISSN Online: 1940-4379

Journal of Long-Term Effects of Medical Implants

DOI: 10.1615/JLongTermEffMedImplants.2014010493
pages 219-224

Management Strategies for Total Hip Arthroplasty in Sickle Cell Patients

Yashika D. Patel
Seton Hall University, School of Health and Medical Sciences, Department of Orthopaedic Surgery, South Orange Village, NJ
Bartlomiej W. Szczech
Seton Hall University, School of Health and Medical Sciences, Department of Orthopaedic Surgery, South Orange Village, NJ
Sujal Patel
Seton Hall University, School of Health and Medical Sciences, Department of Orthopaedic Surgery, South Orange Village, NJ
Kimona Issa
Seton Hall University, School of Health and Medical Sciences, Department of Orthopaedic Surgery, South Orange Village, NJ; Center for Joint Preservation and Replacement, Rubin Institute for Advanced Orthopedics, Sinai Hospital of Baltimore, Baltimore, Maryland
Bhaveen H. Kapadia
Center for Joint Preservation and Replacement, Rubin Institute for Advanced Orthopedics, Sinai Hospital of Baltimore, Baltimore, Maryland; Family Orthopaedic Center, St. Margaret's Hospital, Spring Valley, Illinois; Department of Orthopaedic Surgery and Rehabilitation Medicine, SUNY Downstate Medical Center/University Hospital Brooklyn, Brooklyn, NY
Michael A. Mont
Center for Joint Preservation and Replacement, Rubin Institute for Advanced Orthopedics, Sinai Hospital of Baltimore, Baltimore, Maryland

ABSTRACT

Sickle cell anemia is an inherited hemoglobinopathy in which there is a structural change to the erythrocyte from round to crescent shaped or sickled. These abnormally shaped cells can block small vessels resulting in compromise of vascular supply, pain, and end-organ damage. These patients are particularly susceptible to hip osteonecrosis, which in late stages may require a total hip arthroplasty. Historically, total hip arthroplasty had inferior outcomes in this patient population due to poorer clinical outcomes and higher perioperative complications. During recent decades, however, there have been some improvements in the medical management of these patients, which has potentially improved the clinical outcomes of this procedure. In this article, we review all reported management strategies for the perioperative care of sickle cell anemia patients undergoing total hip arthroplasty.