Massive septic pelvic osteolysis following revision total hip arthroplasty in a patient with sickle cell anemia: clinical presentation and review of the literature

Abstract

Total hip arthroplasty (THA) performed in patients with osteonecrosis, caused by sickle cell disease, carries a higher risk of medical and orthopedic complications, than those observed after THA for osteonecrosis related to other conditions. We report such a case of a male patient, who underwent one-stage revision hip arthroplasty due to septic cup loosening after primary cementless THA and later developed severe septic osteomyelitis of the ipsilateral hemipelvis that had a fatal outcome. The relative literature regarding loosening and infection after THA in patients with sickle cell disease is thoroughly reviewed.

Movement Is Life: Optimizing Patient Access to Total Joint Arthroplasty: Anemia and Sickle Cell Disease Disparities

“…These challenges play a role in the increased risk of implant malposition and prosthetic dislocation in patients with SCD. 18 Osteonecrosis caused by sickle cell disease predisposes patients to postoperative complications, such as aseptic cup loosening, delayed wound healing, revision arthroplasty, osteomyelitis, sepsis, longer length of stay, and increased likelihood of readmission, [19][20][21][22] as summarized in Table 2.…”