Cemented Versus Uncemented Total Hip Arthroplasty in Sickle Cell Disease Patients: A Retrospective Study

Background and objective Sickle cell disease (SCD) can predispose patients to avascular necrosis (AVN) of the femoral head, resulting in severe disabling pain. Total hip arthroplasty (THA) is the leading treatment choice for end-stage arthritis caused by AVN. In this study, we aimed to compare compl...

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Bibliographic Details
Published in:	Curēus (Palo Alto, CA) Vol. 15; no. 3; p. e36138
Main Authors:	Almarzooq, Osama, Alhassan, Mohamed, Alansari, Layla, Alanazi, Turki, Madan, Fatema H
Format:	Journal Article
Language:	English
Published:	United States Cureus Inc 14-03-2023 Cureus
Subjects:	Arthritis Asymptomatic Females Fractures Hemoglobin Hip joint Infections Joint replacement surgery Medical imaging Orthopedics Osteopathic Medicine Other Sickle cell disease Thromboembolism Transplants & implants Bahrain avascular necrosis (avn) hip joint pain cemented total hip arthroplasty cementless total hip arthroplasty sickle cell disease
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Summary:	Background and objective Sickle cell disease (SCD) can predispose patients to avascular necrosis (AVN) of the femoral head, resulting in severe disabling pain. Total hip arthroplasty (THA) is the leading treatment choice for end-stage arthritis caused by AVN. In this study, we aimed to compare complications associated with implant fixation with and without cement. Materials and methods We retrospectively analyzed 95 total hip implants in which 26 patients had staged bilateral THA. These surgeries were performed by four senior arthroplasty consultants between 2007 and 2018. Data were collected from the surgical logbook, physical files, and the electronic patient database (I-Seha, National Health Information System, Ministry of Health, Kingdom of Bahrain). Results The study included 95 hip implants in 69 patients. Forty-five (47%) were in males, and 50 (53%) were in females. Of these, 22 implants underwent revision (23%), two implants had periprosthetic infections (0.2%), two implants had periprosthetic fractures (0.2%), and 18 implants had implant loosening. We found that cemented THA was significantly associated with the development of implant loosening (p<0.001), small particle disease (p<0.001), and a higher revision rate (p<0.001). Conclusion We found that cemented THA in SCD patients led to a higher rate of aseptic implant loosening, mainly caused by osteolysis. Based on our findings, we recommend uncemented THA in SCD patients.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	2168-8184 2168-8184
DOI:	10.7759/cureus.36138