Avascular Necrosis Of Hip Research Articles

Clinical and radiographic outcomes of a trabecular titanium™ acetabular component in hip arthroplasty: results at minimum 5 years follow-up.

BackgroundAim of this prospective study was to evaluate mid-term clinical and radiographic outcomes in total hip arthroplasty using an acetabular cup made of an innovative biomaterial, Trabecular Titanium™, whose highly porous structure and mechanical properties have been designed to mimic those of the natural bone, thus promoting a more physiological load transfer and a more durable fixation.MethodsBetween September 2007 and November 2009, 134 total hip replacements and eight revisions were carried out using DELTA-TT primary cups (Lima Corporate, Villanova di San Daniele del Friuli, Italy) in 133 consecutive patients. Mean age was 57.5 ± 14.7 SD (18–92) years. Diagnosis was primarily hip osteoarthritis in 85 (63 %) cases, developmental dysplasia of the hip (DDH) in 24 (18 %) and hip avascular necrosis (AVN) in 10 (7 %). All the revision procedures were due to aseptic loosening of the original implant. Approval of the Institutional Review Board of the IRCCS Policlinico San Matteo in Pavia was obtained for this study.ResultsMean follow-up was 72.7 ± 7.9 SD (60–86) months. Average Harris Hip Score (HHS) significantly increased from 44.2 ± 5.4 SD (35–52) preoperatively to 95.9 ± 3.5 SD (88–100) at the last follow-up. No major post-operative complications were observed. 99.3 % of the acetabular components were radiographically stable at the last follow-up, without any radiolucent lines, sclerotic areas or periprosthetic osteolysis. Kaplan-Meier survival rate was 99.3 % at 5 years (95 % confidence interval).ConclusionsThis first account on the mid-term clinical performance of the DELTA-TT cup shows primary and secondary stability, thus representing an optimal solution for patients with high demands or affected by severe hip conditions.

Clinical effect of 7.5 mm QWIX screw fixation of femoral neck fracture

Objective To evaluate the clinical effect of femoral neck fracture fixed with 7.5mm QWIX screws and to find out risk factors for avascular necrosis of the femoral head postoperatively. Methods From January 2009 and March 2013, 53 patients underwent closed or open reduction of femoral neck fracture with 7.5mm QWIX screws. Healing process of fracture, complications of internal fixation, Harris hip score and avascular necrosis of the femoral head were followed up. The data reviewed were age, gender, injury patterns, fracture type, preoperative waiting time, reduction ways, reduction condition, and others. Unilateral and multivariate Logistic analysis were applied to identify factors for avascular necrosis of the femoral head. Results All patients were followed up for 2-5 years (mean, 3.4 years). There was no non-union at follow-up, and all the screws were in the original site without loosening, cut-out or penetration. Mean Harris score was 91.2 points (range, 68 to 100 points) 2 years after operation, including 42 excellent, 6 good, 1 fair and 4 poor results with the excellent-good rate of 91%. Four patients (8%) had avascular necrosis 12 to 15 months after operation. With Logistic regression analysis, fracture anatomic type was identified as the only factor for avascular necrosis of the femoral head. Conclusions The 7.5 mm QWIX fixation screw provides rigid fixation, high healing rate and low incidence of avascular necrosis of the femoral head, appearing to be a good hardware to repair femoral neck fracture. Avascular necrosis of the femoral head is associated with the anatomic type of femoral neck fracture after operation. Key words: Femoral neck fractures; Internal fixators; Femur head necrosis; 7.5 mm QWIX screws

Bipolar hip arthroplasty for avascular necrosis of femoral head in young adults.

Background:Bipolar hip arthroplasty (BHA) is one of the options for treatment of avascular necrosis (AVN) of the femoral head. Acetabular erosion and groin pain are the most allowing for gross motion between the common complications. We propose that these complications are secondary to improper acetabular preparation allowing for motion between the BHA head and the acetabulum.Materials and Methods:The current study retrospectively evaluated patients’records from case files and also called them for clinical and radiological followup. 96 hips with AVN of the femoral head treated with BHA were included in the study. All patients were males with a mean age of 42 years (range 30-59 years). In all cases, the acetabulum was gently reamed till it became uniformly concentric to achieve tight fitting trial cup. Clinical followup using Harris hip score (HHS) and radiological study for cup migration were done at followup.Results:The mean followup was 7.52 years (range 4-16 years). The HHS significantly improved from a preoperative value of 39.3 (range, 54-30) to a postoperative value of 89.12 (range 74-96). According to HHS grades, the final outcome was excellent in 52 hips, good in 28 and fair in 16 hips. Hip and groin pain was reported in four hips (5%), but did not limit activity. Subsidence (less than 5 mm) of the femoral component was seen in 8 cases. Subgroup analysis showed patients with Ficat Stage 3 having better range of motion, but similar HHS as compared to Ficat Stage 4 patients.Conclusion:Bipolar hip arthroplasty (BHA) using tight fitting cup and acetabular reaming in AVN hip has a low incidence of groin pain, acetabular erosion and revision in midterm followup. Good outcome and mid term survival can be achieved irrespective of the Ficat Stage.

MRI Evaluation of Post Core Decompression Changes in Avascular Necrosis of Hip.

Avascular necrosis of hip typically presents in young patients. Core decompression in precollapse stage provides pain relief and preservation of femoral head. The results of core decompression vary considerably despite early diagnosis. The role of MRI in monitoring patients post surgically has not been clearly defined. To study pre and post core decompression MRI changes in avascular necrosis of hip. This is a contiguous observational cohort of 40 hips treated by core decompression for precollapse avascular necrosis of femoral head, who had a baseline MRI performed before surgery. Core decompression of the femoral head was performed within 4 weeks. Follow up radiograph and MRI scans were done at six months. Harris hip score preoperatively, 1 month and 6 months after the surgery was noted. Success in this study was defined as postoperative increase in Harris hip score (HHS) by 20 points and no additional femoral collapse. End point of clinical adverse outcome as defined by fall in Harris hip score was conversion or intention to convert to total hip replacement (THR). MRI parameters in the follow up scan were compared to the preoperative MRI. Effect of core decompression on bone marrow oedema and femoral head collapse was noted. Results were analysed using SPSS software version. Harris hip score improved from 57 to 80 in all patients initially. Six hips had a fall in Harris hip score to mean value of 34.1 during follow up (9 to 12 months) and underwent total hip replacement. MRI predictors of positive outcome are lesions with grade A extent, Grade A & B location. Bone marrow oedema with lesions less than 50% involvement, medial and central location. Careful selection of patients by MR criteria for core decompression provides satisfactory outcome in precollapse stage of avascular necrosis of hip.

Dolor atraumático de cadera en adulto joven

Hip pain in the young adult is a disabling pathophysiological process may be related to multiple etiologies. The process must be determined in order to make a diagnosis and follow-up treatment. The case is presented of a 29 year old woman with anemia, atraumatic hip pain on the right side, and a limp of one month onset. The differential diagnosis includes infectious, rheumatological, tumor, avascular necrosis of hip, hip impingement, hip dysplasia, osteoarthritis and other syndromes.

Avascular necrosis of the hip and diffuse idiopathic skeletal hyperostosis during long‐term isotretinoin treatment of epidermolytic ichthyosis due to a novel deletion mutation in KRT10

Avascular necrosis of the hip and diffuse idiopathic skeletal hyperostosis during long‐term isotretinoin treatment of epidermolytic ichthyosis due to a novel deletion mutation in <scp> <i>KRT10</i> </scp>

FRI0157 Rheumatologic Manifestations in Inflammatory Bowel Disease Patients Referred to the Rheumatology Service in A Tertiary Referral Center

BackgroundMusculoskeletal manifestations occur in 20-50% of patients (pts) with inflammatory bowel disease (IBD) and they have an impact on the clinical course and therapeutic approach.ObjectivesTo summarize the rheumatologic manifestations of...

THE USE OF MOTION ANALYSIS SYSTEM AND ORTHOSIS IN PATIENTS WITH NEURO-MUSCULOSKELETAL DISORDERS

Background: Neuro-musculoskeletal disorders are a major source of physical disability involving more than one joint. Monitoring all joints during walking is achieved by using motion analysis system. There is limited evidence to show the suitability of motion analysis system to monitor neuro-musculoskeletal disorders. This research investigated the feasibility of this system to represent in patients with neuro-musculoskeletal disorders during walking. Method: Five groups of normal subjects with: knee osteoarthritis; avascular necrosis of hip joint; spinal cord injury and flat foot were recruited into this study. Kinetic and kinematic parameters were obtained by the use of motion analysis (Qualysis with seven cameras) and a Kistler force platform. The differences between gait parameters of normal and subjects with these disorders were examined using the independent t-tests. Paired t-test analysis was also used to determine the difference between walking with and without orthosis. Significant value was set at p ≤ 0.05. Results: There was a significant difference between the moment applied on the knee joint, the integral area between center of pressure (COP) and center of knee joint (COJ) graphs of normal and osteoarthritis (OA) subjects (p &lt; 0.05). The area between COP and COJ of the ankle joint significantly differed between normal and flat foot subjects (p &lt; 0.05). However, the force transmitted through the hip joint in subjects with Perthes did not differ significantly while walking with and without orthosis. In paraplegic subjects, the force applied on the limb and the mean values of gait parameters varied while walking with different orthoses which showed the feasibility of the system to monitor the performance of subjects with SCI disorder. Conclusion: The findings of the present study imply that the use of motion analysis is feasibility for assessing and monitoring neuro-musculoskeletal disorders. However, different parameters should be selected for various neuro-musculoskeletal disorders.

Bilateral Total Hip Replacement in Steroid Induced AVN in A Young Patient

A 30 years old female patient presented us with pain, restricted movement of hip and difficulty of walking. She had past history of taking oral Steroid for 6 months for gaining weight. Radiological examination revealed bilateral avascular necrosis of hips with advanced osteoarthritic changes. The patient had sequential Total hip replacement on both sides in 6 weeks interval. Post operatively she was uneventful and after proper exercise and physiotherapy she is maintaining her daily household activities smoothly. DOI: http://dx.doi.org/10.3329/bjms.v13i2.18304 Bangladesh Journal of Medical Science Vol.13(2) 2014 p.205-208

A80: Skeletal Features of Neonatal‐Onset Multisystem Inflammatory Disease (NOMID) on Anakinra Treatment: Long‐Term Follow‐up

Background/Purpose:Neonatal‐onset multisystem inflammatory disease (NOMID) is an autoinflammatory disease characterized by fever, chronic urticarial rash, CNS manifestations, elevated acute phase reactants, and arthropathy. About 50% of patients with NOMID have de novo missense mutations in NLRP3/CIAS1, leading to constitutive inflammasome activation and IL‐1 production in monocytes, and caspase‐1 mediated persistence of osteoblast progenitor cells that are also found in other fibroblastoid tumors (). Poorly differentiated chondrocytes are seen with abnormal enchondral bone formation without inflammatory cells in NOMID arthropathy with bony overgrowth and premature fusion of physis. While blocking IL‐1 with anakinra reduces organ‐specific (central nervous system, inner ear, eye) and systemic inflammation (fever, rash, acute phase reactants), it has little effect on preexisting bone lesions.Methods:NOMID individuals with at least 5 months of follow up data (clinical, laboratory, and radiographic) on IL‐1 blocking treatment were included for review.Results:18 (36.7%) of the NOMID patients (n = 49; 21 male/28 female; age at study entry: 9.4 yo, 0.8–46.3 yo; duration of follow‐up: 4.6 yrs, 0.4–9.5 yrs) had bony involvement, most commonly the knee (16/49 = 32.7%, 12/49 = 24.5% with patellar involvement). 11/49 (22.4%) had multi‐joint involvement, typically asymmetric, including 4 elbows, 5 wrists, 6 ankles, 3 shoulders, and 2 hips. Ongoing abnormal enchondral bone formation continues until physeal fusion, which often occurs prematurely at involved sites, despite anaanakinra treatment. Lesions eventually ossify normally but may cause bone deformities. 3 patients had patellar subluxations (1 managed surgically) and 2 had patella resections. Leg length discrepancy (8/49 = 16.3%) and bowed leg deformities (9/49 = 18.3%) present due to premature, asymmetric fusion of physis required osteomy and/or stapling in 3. 2 developed long twisted fibula to accommodate shortened tibia, 1 surgically managed with stapling. One individual developed hip subluxation due to a longer left leg, which resulted in left hip avascular necrosis. 2 individuals had pseudofractures with development of horizontal linear defects noted in long‐bones consistent with residual changes from abnormal enchondral ossification rather than true fracture. 1 individual developed severe contractures with bilateral knee arthropathy and subsequently had bilateral total knee replacement.Conclusion:1. Unique bony findings in NOMID are due to persistence of immature osteoblast precursors with abnormal enchondral bone growth which continues until physeal fusion despite anakinra treatment, often with premature fusion at affected sites, with eventual normal ossification. 2. Surgical intervention can be safely considered for those with significant pain/disability from NOMID arthropathy. 3. Consideration of horizontal linear pseudofractures in long bones and risk of hip avascular necrosis is important in those with NOMID ().

Avascular necrosis of hip (AVN) in post renal transplant recipient: Case report & review of literature

Avascular necrosis of the femoral head is one of the most common skeletal complications among renal allograft recipients complaining of hip pain. While bilateral avascular necrosis is more frequent than the unilateral type, we report a case of unilateral avascular necrosis of the hip occurring post renal transplant recipient. Avascular necrosis was likely the result of steroid therapy. A well-tailored steroid therapy that prevents unjustified high doses and ‘pulsed doses’ while maintaining the optimum maintenance level of steroids is necessary.

Immediate mobilisation with complete weight bearing after uncemented total hip replacement in elderly

This prospective study was analyzed in 23 patients who were allowed to do immediate weight bearing after uncemented total hip arthroplasty. Immediate mobilization shortened the hospital stay and facilitated early rehabilitation of hip. Immediate mobilization was started on postoperative Day 3 rather than Day 7 without any adverse consequences to the patients. A series of 23 elderly patients of age more than 60 years, who were diagnosed with conditions such as avascular necrosis of hip, non union of fracture neck of femur, trochanteric non union and rheumatoid arthritis, underwent uncemented total hip replacement and immediate mobilization was started in our hospital. Patients were evaluated by Harris Hip Scoring Scale. All ambulated patients had painless hip and the mean Harris Hip Score was 85. There were no incidence of stem subsidence, acetabular component loosening, and heterotrophic ossification. This data concluded that early intensive rehabilitation yielded faster attainment of short-term functional milestones in fewer days.

Comparison of Two PCR-Based Genetic Fingerprinting Methods for Assessment of Genetic Diversity in Saccharomyces Strains

<b>1335</b> <h3><b>Learning Objectives</b></h3> 1. Present the imaging findings of FDG PET/CT, bone scan, Gallium scan, MRI and CT of hairy cell leukemia (HCL) with isolated bone lesions 2. Review clinical presentation and treatment of HCL, a rare B-cell lymphoproliferative disorder 3. Describe and compare the pathological findings of HCL and B-cell lymphoma <h3></h3> A 50 year old male presented with right hip pain. An MRI showed bilateral hip avascular necrosis. He subsequently had right hip decompression and bone graft, with the pathology showing increased lymphocytes of uncertain significance. Due to persistent right hip pain, a follow-up MRI was performed 2 years later which showed marrow replacing lesion in the right proximal femur that involved the epiphyses. A chest and abdominal CT identified anterior mediastinal, right paracardiac, retrocrural, and retroperitoneal lymphadenopathies. Core needle biopsies of the left paraspinal soft tissue mass were positive for lymphoid cell infiltration, with the morphological and immunophenotypic features in favor of nodal marginal zone lymphoma. However, the presence of positive cyclin D1 staining raised the possibility of a mantle cell lymphoma. Bone scan and Gallium scan were performed to rule out osteomyelitis. Susequently, bony lesions from the right femoral head and neck were biopsied and the final diagnosis is HCL. The original pathology from the paraspinal mass was reviewed and is consistent with HCL. The patient was later treated with a 5 day course of cladribine and on follow-up FDG PET/CT study was free of any disease in the right hip. HCL is a rare hematological malignancy representing 2% of all leukemias, with about 700 new cases diagnosed annually in the United States. We present a case of HCL in a male with persistent right hip pain, with unusual initial presentation of the bony lesions, followed 3 years later by soft tissue masses. In addition, the initial soft tissue biopsy was misdiagnosed as nodal marginal zone lymphoma. The distinction between hairy cell leukemia and marginal zone lymphoma is often difficult as they have many overlapping features.

Phenomenon of cartilage micro-crystallization in hip osteoarthritis and avascular necrosis of the femoral head

Phenomenon of cartilage micro-crystallization in hip osteoarthritis and avascular necrosis of the femoral head

AB0402 Avascular necrosis of hip in korean patients with systemic lupus erythematosus: risk factors and clinical outcome

BackgroundAVN is a common manifestation in patients with systemic lupus erythematosus (SLE), which can cause significant disability. Nevertheless, the exact pathogenetic mechanism has not been clarified.ObjectivesTo identify the risk factors...

Revolutionize it - Time for big change.

Revolutionize it - Time for big change.

Gait Findings in the Adolescent Subject With a Stiff Hip

Adolescent subjects with severe unilateral hip disease are often stiff and painful yet have limited surgical options. Although hip fusion has been used successfully to minimize pain, acquired gait compensations after arthrodesis are factors felt to lead to knee and back pain over time. However, these gait compensations may already be present in a person with a stiff hip. The purpose of this study was to describe the quantitative gait findings of the adolescent subject with a unilateral stiff hip and to determine whether these findings are similar to those of subjects presenting after arthrodesis. This study was a retrospective review of 6 subjects seen in a motion analysis laboratory between 2005 and 2009 (age 13 to 17 y). All adolescents had been referred to the motion analysis laboratory for a routine clinical gait study. Subjects were selected for this study based on kinematic sagittal plane hip motion found to be < 25 degrees (mean 16.2 degrees). Diagnoses included: Legg-Calvé-Perthes (3) and hip avascular necrosis (3). Compared with laboratory-based normative data, the following findings were significant: increased arc of trunk and pelvic motion (sagittal, coronal); involved side--decreased arc of hip and knee motion (sagittal), decreased peak hip abduction in swing; contralateral side--increased arc of hip and knee motion (sagittal); and increased peak hip abduction in swing. Gait compensations in multiple planes and joints were identified in adolescent subjects with a unilateral stiff hip. These compensations are necessary for these subjects to generate forward progression in gait and are similar to deviations found after hip arthrodesis. Subjects with a stiff hip may already be at risk to develop pain and/or arthrosis in adjacent motion segments due to these obligatory gait characteristics. Hip fusion may not increase these risks (in this patient population) since the compensations are already present and requisite, but may provide an opportunity to decrease pain and improve function. Level IV, Case Series.

HER İKİ KALÇADA AYNI ANDA GELİŞEN İDYOPATİK BİLATERAL AVASKÜLER NEKROZ: OLGU SUNUMU

Avascular necrosis is the cellular death of bone caused by deterioration of blood flow from various reasons. Here, a case with bilateral avascular necrosis of both hips developing at the same time is presented. 50-year old male patient applied to our clinic with the complaint of pain in both hips for 2 months. His history was unremarkable. On physical examination, both hip movements were painful. MR imaging of both hips was reported as mild focal irregularity at the top of the femoral head. The patient was diagnosed with bilateral idiopathic avascular necrosis. As a result, usually hip avascular necrosis is seen unilaterally. However, sometimes as in our patient, both hips may be affected simultaneously without any revealed etiological factor

Outcomes of osteoporotic trochanteric fractures treated with cement-augmented dynamic hip screw

Background:Dynamic hip screw (DHS) has been the standard treatment for stable trochanteric fracture patterns, but complications of lag screw cut out from a superior aspect, due to inadequate bone anchorage, occur frequently in elderly osteoporotic patients. Polymethylmethacrylate (PMMA) has been used as an augmentation tool to facilitate fixation stability in cadaveric femora for biomechanical studies and in pathological fractures. However, there are very few reports on the utilization of PMMA cement to prevent these complications in fresh intertrochanteric fractures. A prospective study was conducted to evaluate the outcome and efficacy of PMMA augmented DHS in elderly osteoporotic patients with intertrochanteric fractures.Materials and Methods:The study included 64 patients (AO type31-A2.1 in eight, A2.2 in 29, A2.3 in 17 patients, and 31-A3.1 in five, A3.2 in three, and A3.3 in two patients) with an average age of 72 years (60 – 94 years) of which 60 were available for final followup. PMMA augmentation of DHS was performed in all cases by injecting PMMA cement into the femoral head with a custommade gun designed by the authors. The clinical outcome was rated as per the Salvati and Wilson scoring system at the time of final followup of one year. Results were graded as excellent (score > 31), good (score 24 – 31), fair (score 16 – 23), and poor (score < 16).Results:Fracture united in all patients and the average time to union was 13.8 weeks (range 12 – 16 weeks). At an average followup of 18 months (range 12 – 24 months), no incidence of varus collapse or superior screw cut out was observed in any of the patients in spite of weightbearing ambulation from the early postoperative period. There was no incidence of avascular necrosis (AVN) or cement penetration into the joint in our series. Most of the patients were able to regain their prefracture mobility status with a mean hip pain score of 8.6.Conclusion:Cement augmentation of DHS appears to be an effective method of preventing osteoporosis related complications of fracture fixation in the trochanteric fractures. The technique used for cement augmentation in the present study is less likely to cause possible complications of cement augmentation like thermal necrosis, cement penetration into the joint, and AVN hip.

Reduction of the Six-Minute Walk Distance in Children with Sickle Cell Disease Is Correlated with Silent Infarct: Results From a Cross-Sectional Evaluation in a Single Center in Belgium.

AbstractAbstract 2107▪▪This icon denotes a clinically relevant abstractThe 6-minute walk test (6MWT) evaluates the sub-maximal functional exercise capacity and can be used together with the tricuspid regurgitant jet velocity (TRV) and pro-BNP to screen pulmonary hypertension in adults with sickle cell disease (SCD). A reduced 6-minute walk distance (6MWD) is observed in adults with SCD with chronic pain, hip avascular necrosis and osteopenia. In children with SCD, baseline elevated TRV is associated with a decline in age-standardized 6MWD.The aim of our study is to explore the submaximal exercise capacity of children with SCD followed at the Hôpital Universitaire des Enfants Reine Fabiola, Brussels, Belgium and to analyze the factors affecting the 6MWT and the 6MWD.Since September 2011, all patients with SCD above 6 years of age were screened with the 6MWT as part of their follow-up in order to test if their functional capacity was altered. The age-standardized predicted value of the 6MWD was established as reported by Geiger. The 6MWT was considered as normal if the 6MWD was more than 80% of the age-standardized predicted value, moderately decreased between 60–80%, and severely altered less than 60%. Baseline hematological values, clinical events, cerebro-vascular disease, cardio-pulmonary parameters and disease-modifying treatment (DMT) were compared between those with normal and abnormal 6MWT and according to the 6MWD.Forty-six patients (20 boys and 26 girls) with a median age of 12 yrs were investigated. Forty-three were HbSS or HbSβ°, 2 HbSC and 1 HbSβ+. Thirty-two patients had a normal 6MWT and 14 an abnormal 6MWT. Only one patient had a severely altered test. These 2 groups were similar for age, sex, genotype and history of vaso-occlusive crisis or acute chest syndrome (ACS) as well as for the number of patients receiving DMT (either hydroxyurea (HU) or chronic transfusion). The proportion of patients with normal, conditional or abnormal transcranial doppler was also similar in both groups. Silent infarct (SI) on routine cerebral magnetic resonance imaging was found in 42.9% in the group with abnormal 6MWT versus only 19.4% in the group with normal 6MWT (p= 0.087). Pulmonary functional test, blood pressure, heart rate, systolic function and TRV were identical in both groups and only one patient had TRV >2.5m/sec. Baseline pulse oxymetry was slightly but significantly decreased in patients with abnormal 6MWT (98 versus 100%; p=0.022). Biological parameters were not statistically different between both groups. The 6MWD was not modified according to Hb, MCV, HbF, LDH and reticulocytes count or previous history of clinical event, except for the presence of SI (Table 1). Patients with or without SI were similar for age, sex, previous ACS or painful crisis as well as for hemolytic parameters (LDH: 945 versus 825 UI/l, p=0.832; reticulocytes: 273 versus 329 × 103/μl, p=0.548) and basal Hb (9.7 versus 8.8 g/dl, p=0.06). However patients without SI had significantly higher HbF and MCV values, and lower PMN count reflecting that most of them were treated with HU.In this cross-sectional study, the majority of children with SCD have a normal 6MWT. Abnormal 6MWT was not predicted by any clinical or biological features despite a trend to more SI in the group of children with abnormal test. In this series with only one high TRV patient, the sole factor which influences the 6MWD is the presence of SI. The lower exercise capacity of children with SCD with silent stroke may reflect some subclinical motor or sensitive impairment. Our data suggest also that HU might prevent SI which needs to be confirmed by larger prospective studies.Table 16-minute walk distance (6MWD) in 46 SCD children according to their biological values and clinical complicationsMean 6MWD in meters (SD)p valueMean Age in years (SD)p valueHemoglobin (g/dl)· ≥ 9 (N = 24)531.5 (95.4)0.17311.2 (2.8)<0.001· < 9 (N = 22)569.8 (92.2)14.5 (2.7)MCV (fL)· ≥ 90 (N = 24)536.1 (100.7)0.25112.6 (3.5)0.518· < 90 (N = 22)568.3 (86.8)13.2 (2.8)HbF (%)*· ≥ 10% (N = 30)544.0 (101.7)0.36013.2 (3.5)0.352· <10% (N = 15)570.1 (81.8)12.6 (2.4)LDH (UI/l)· ≥ 1000 (N = 14)526.8 (86.5)0.22911.8 (3.0)0.105· < 1000 (N = 32)562.3 (97.4)13.4 (3.1)Previous ACS*· Yes (N = 38)548.6 (98.3)0.62513.5 (3.1)0.453· No (N = 7)566.9 (85.5)12.5 (4.2)Silent Infarct· Yes (N = 12)502.5 (113.9)0.03512.1 (2.2)0.374· No (N = 34)568.9 (82.0)13.2 (3.4)*Missed information for 1 patient. Disclosures:No relevant conflicts of interest to declare.