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© 1986 British Society for Rheumatology

research-article

ASEPTIC NECROSIS OF THE FEMORAL HEAD IN SICKLE-CELL DISEASE

W. W. EBONG1, and T. M. KOLAWOLE2

1Departments of Surgery, College of Medicine, University of Ibadan Nigeria
2Departments of Radiology, College of Medicine, University of Ibadan Nigeria

Correspondence to: Address correspondence to Dr Walton W. Ebong, Department of Surgery, University College Hospital, Ibadan, Nigeria.

Aseptic necrosis of the femoral head accounted for 75 (28.2%) of the 266 major skeletal complications seen in 207 patients with sickle-cell disease in a 66-month period. Forty-five (60%) of the 75 patients were males. The onset of symptoms occurred between 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 46 hips affected by necrosis, and 38 patients with sickle-cell haemoglobin C with 40 affected hips. Perthes-like changes occurred in 40 hips, osteochondritis dissecans-like lesion in one hip and severe hip deformity in 45 hips. Four of the five hips with Perthes-like necrosis which were treated by rotation upper femoral osteotomy had partial reconstitution of the femoral head, and all five were symptom-free. The other hips were treated conservatively with generally poor results.

KEY WORDS: Femoral head necrosis, Osteonecrosis, Anaemia, sickle-cell


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