Cementless Total HIP Replacements in Sickle Cell Disease

2015 ◽  
Vol 26 (2) ◽  
pp. 186-192 ◽  
Author(s):  
Christopher M. Jack ◽  
Jo Howard ◽  
Emad S. Aziz ◽  
Rachel Kesse-Adu ◽  
Marcus J. Bankes
2019 ◽  
Vol 4 (9) ◽  
pp. 567-575 ◽  
Author(s):  
Akintunde George ◽  
Marianne Ellis ◽  
Harinderjit Singh Gill

Many studies in the literature have been carried out to evaluate the various cellular and molecular processes involved in osteogenesis. Angiogenesis and bone formation work closely together in this group of disorders. Hypoxia-inducible factor (HIF) which is stimulated in tissue hypoxia triggers a cascade of molecular processes that helps manage this physiological deficiency. However, there still remains a paucity of knowledge with regard to how sickle cell bone pathology, in particular avascular necrosis, could be altered when it comes to osseointegration at the molecular level. Hypoxia-inducible factor has been identified as key in mediating how cells adapt to molecular oxygen levels. The aim of this review is to further elucidate the physiology of hypoxia-inducible factor with its various pathways and to establish what role this factor could play in altering the disease pathophysiology of avascular necrosis caused by sickle cell disease and in improving osseointegration. This review article also seeks to propose certain research methodology frameworks in exploring how osseointegration could be improved in sickle cell disease patients with total hip replacements and how it could eventually reduce their already increased risk of undergoing revision surgery.Cite this article: EFORT Open Rev 2019;4:567-575. DOI: 10.1302/2058-5241.4.180030


2002 ◽  
Vol 26 (3) ◽  
pp. 157-161 ◽  
Author(s):  
Al-Mousawi F. ◽  
Malki A. ◽  
Al-Aradi A. ◽  
Al-Bagali M. ◽  
Al-Sadadi A. ◽  
...  

2011 ◽  
Vol 3 (1) ◽  
pp. 1 ◽  
Author(s):  
Alexandre Poignard ◽  
Mohamed Bouhou ◽  
Yasuhiro Homma ◽  
Philippe Hernigou

Although the presence of osteonecrotic bone is known to make joints more prone to infection, acute septic joint in hip osteonecrosis has not frequently been reported in adults with sickle cell disease. The clinical features at the time of admission, imaging findings suggesting the diagnosis, modes of treatment and sequelae of septic arthritis of twenty-four hip joints with osteonecrosis in patients with sickle cell disease were studied retrospectively over a 25-years period. This study evaluated also the complications, the efficiency and the risk of total hip arthroplasty in these patients. Most patients were in the third decade of life. Staphylococcus and Gram negative infection predominated. Treatment was first conservative but most of the patients needed surgery to treat infection and sequelae related to infection. A total hip arthroplasty was performed later in twenty joints. No deaths were observed, but complications occurred. Twenty of the patients in our study underwent delayed total hip arthroplasties following repeated aspirations of the joint and intravenous antibiotics. With an experienced surgical and medical team and multidisciplinary management of these patients undergoing total hip arthroplasty after hip infection, our rate of complications was acceptable.


Hematology ◽  
2019 ◽  
Vol 2019 (1) ◽  
pp. 351-358 ◽  
Author(s):  
Oyebimpe O. Adesina ◽  
Lynne D. Neumayr

Abstract Osteonecrosis, a form of ischemic bone injury that leads to degenerative joint disease, affects ∼30% of people with sickle cell disease. Although osteonecrosis most commonly affects the femoral head (often bilaterally, with asymmetric clinical and radiographic progression), many people with sickle cell disease also present with multifocal joint involvement. We present the case of a young woman with bilateral osteonecrosis of the femoral head at varying stages of progression; we also highlight other important comorbid complications (eg, chronic pain requiring long-term opioids, debility, and social isolation) and postoperative outcomes. In this review, partly based on recommendations on osteonecrosis management from the 2014 evidence-based report on sickle cell disease from the National Heart, Lung and Blood Institutes, we also discuss early signs or symptoms of osteonecrosis of the femoral head, radiographic diagnosis and staging criteria, hydroxyurea effect on progression to femoral head collapse, and surgical outcomes of total hip arthroplasty in the modern era. In summary, we failed to find an association between hydroxyurea use and femoral head osteonecrosis; we also showed that evidence-based perioperative sickle cell disease management resulted in superior postoperative outcomes after cementless total hip arthroplasty in sickle cell–related osteonecrosis of the femoral head.


Sign in / Sign up

Export Citation Format

Share Document