Total Hip Arthroplasty in Sickle Cell Disease


  • Mojieb Manzary Johns Hopkins Aramco Health Care Center, Dhahran, Saudi Arabia



hip arthroplasty, sickle cell anaemia


Sickle cell disease (SCD) is a hemoglobinopathy characterized by abnormal morphology of blood cells causing transient interruption of blood supply to various body parts. Femoral Head avascular necrosis is one of the commonest skeletal sequeale of SCD.

Total Hip arthroplasty (THA) in SCD has evolved through different stages with a spectrum of results and technical challenges.

This article reviews the pathologic basis of sickle cell disease , the various challenges perioperatively associated with THA in SCD.

Author Biography

Mojieb Manzary, Johns Hopkins Aramco Health Care Center, Dhahran, Saudi Arabia

Department of  Orthopedics



Acurio, M. T., & Friedman, R. J. (1992). Hip arthroplasty in patients with sickle-cell haemoglobinopathy. J Bone Joint Surg Br, 74(3), 367-371. Retrieved from

Al-Mousawi, F. (2004). Complications and failures of hip replacement in sickle cell disease. Bahrain Medical Bulletin, 26(4), 134-138.

Charache S, Terrin ML, Moore RD, Dover GJ, Barton FB, Eckert SV, et al. Effect of hydroxyurea on the frequency of painful crises in sickle cell anemia. Investigators of the Multicenter Study of Hydroxyurea in Sickle Cell Anemia. N Engl J Med. 1995 May18;332(20):1317-22.

Clarke, H. J., Jinnah, R. H., Brooker, A. F., & Michaelson, J. D. (1989). Total replacement of the hip for avascular necrosis in sickle cell disease. J Bone Joint Surg Br, 71, 465-470.

Edington GM, Lehmann H. Expression of the sickle-cell gene in Africa. British medical journal. 1955 May 28;1(4925):1308-11

Ficat RP. Idiopathic bone necrosis of the femoral head. Early diagnosis and treatment. J Bone Joint Surg Br. 1985 Jan;67(1):3-9.

Hernigou, P., Bachir, D., & Galacteros, F. (2003). The natural history of symptomatic osteonecrosis in adults with sickle-cell disease. The Journal of bone and joint surgery. American volume, 85-A(3), 500-4. Retrieved from

Hernigou, P., Habibi, a, Bachir, D., & Galacteros, F. (2006). The natural history of asymptomatic osteonecrosis of the femoral head in adults with sickle cell disease. The Journal of bone and joint surgery. American volume, 88(12), 2565-2572.

Hernigou P, Galacteros F, Bachir D, Goutallier D. Deformities of the hip in adults who have sickle-cell disease and had avascular necrosis in childhood. A natural history of fifty-two patients. J Bone Joint Surg Am. 1991 Jan;73(1):81-92.

Hernigou, P., Zilber, S., Filippini, P., Mathieu, G., Poignard, A., & Galacteros, F. (2008). Total THA in adult osteonecrosis related to sickle cell disease. Clinical Orthopaedics and Related Research (Vol. 466, pp. 300-308).

Jeong, G. K., Ruchelsman, D. E., Jazrawi, L. M., & Jaffe, W. L. (2005). Total hip arthroplasty in sickle cell hemoglobinopathies. The Journal of the American Academy of Orthopaedic Surgeons, 13(3), 208-17. Retrieved from

Perfetti, D. C., Boylan, M. R., Naziri, Q., Khanuja, H. S., & Urban, W. P. (2015). Does sickle cell disease increase risk of adverse outcomes following total hip and knee arthroplasty? A nationwide database study. J Arthroplasty, 30(4), 547-551. Retrieved from

Powars DR, Chan LS, Hiti A, Ramicone E, Johnson C. Outcome of sickle cell anemia: a 4-decade observational study of 1056 patients. Medicine (Baltimore). 2005 Nov;84(6):363-76.

Steinberg ME, Hayken GD, Steinberg DR. A quantitative system for staging avascular necrosis. J Bone Joint Surg Br. 1995 Jan;77(1):34-41

Stuart MJ, Nagel RL. Sickle-cell disease. Lancet. 2004 Oct 9-15;364 (9442):1343-60.




How to Cite

Manzary, M. (2016). Total Hip Arthroplasty in Sickle Cell Disease. Reconstructive Review, 6(2).