Total Hip Arthroplasty: Sickle Cell Disease

Description

Dr Jonathan Vigdorchik gives his insights and discusses the complexities involved in performing total hip arthroplasty for patients with sickle cell disease. Dr Vigdorchik outlines key medical challenges that must be addressed prior to the surgical procedure, including the optimization of patients' hemoglobin levels and hydration. These patients are often treated with warm intravenous fluids to prevent crises. The surgical technique presents additional difficulties due to the brittle nature of the bone, often compromised by avascular necrosis, which can break easily despite its hardness. Surgeons are advised to use specific preparation techniques, like reaming, rather than broaching the femoral canal, and to employ fluoroscopic guidance to navigate the tight bone structure. Throughout the surgery and postoperative care, maintaining warmth and careful management of hemoglobin levels are crucial to avoid complications related to sickle cell disease.

DOI: 10.1302/3114-251140

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