ASEPTIC NECROSIS OF THE FEMORAL HEAD IN SICKLE-CELL DISEASE

Aseptic necrosis of the femoral head accounted for 75 (28.2%)of the 266 major skeletal complications seen in 207 patientswith sickle-cell disease in a 66-month period. Forty-five (60%)of the 75 patients were males. The onset of symptoms occurredbetween the ages of 10 and 29 years in 60 (80.0%) of the patients,and the mean age at onset was 20.8 (range 8–54) years.There were 37 patients with sickle-cell anaemia (SS) with 46hips affected by necrosis, and 38 patients with sickle-cellhaemoglobin C with 40 affected hips. Perthes-like changes occurredin 40 hips, osteochondritis dissecans-like lesion in one hipand severe hip deformity in 45 hips. Four of the five hips withPerthes-like necrosis which were treated by rotation upper femoralosteotomy had partial reconstitution of the femoral head, andall five were symptom-free. The other hips were treated conservativelywith generally poor results. KEY WORDS: Femoral head necrosis, Osteonecrosis, Anaemia, sickle-cell