Choice of implant in total hip arthroplasty for sickle cell disease patients

Abstract

This study was conducted to analyze the outcome of cemented versus cementless total hip arthroplasty (THA) in patients with sickle cell disease (SCD). One hundred eighteen SCD patients underwent 136 primary THA for avascular necrosis of the femoral head. Forty-six hips were cemented, and 90 were cementless. Patients were followed up 2–16 years. All patients showed improvement in clinical score. In cemented prosthesis group, 61% (28) failed, compared to 22.3% (20) failure in cementless group (p = 0.001). Furthermore, in cementless THA, failure was higher in proximally coated femoral stems (27.8%) than in fully coated stems (18.5%). Kaplan–Meier survivorship analysis, with the end point defined as failure of the implant, showed a significantly longer duration of clinical survival of cementless than cemented THAs (log rank test, p < 0.01). Cox regression analysis showed that cementless THAs were 76% less likely to fail compared to cemented THA. In SCD patients, cementless total hip implants have a better chance of long-term survival compared to cemented implants.