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  • Title: [Total hip arthroplasty for the treatment of septic hip arthritis in adults with sickle-cell disease].
    Author: Hernigou P, Odent T, Manicom O, Nogier A, Bachir D, Galacteros F.
    Journal: Rev Chir Orthop Reparatrice Appar Mot; 2004 Oct; 90(6):557-60. PubMed ID: 15672923.
    Abstract:
    PURPOSE OF THE STUDY: Septic hip arthritis is a recognized complication of sickle-cell disease. The incidence is difficult to assess but is significant since certain authors estimate that 11% of children with sickle-cell disease develop orthopedic complications. We report our experience with hip joint infection in adults with sickle-cell disease. MATERIAL AND METHODS: We diagnosed ten cases of hip joint infection in seven adults with sickle-cell disease. The characteristic feature of the septic arthritis was the development of a septic focus in a zone of osteonecrosis of the femoral head. Diagnosis was difficult due to the presence of prior hip disease and also the circumstances of development: other infectious foci, septicemia, distant osteomyelitis. The diagnosis was confirmed by joint puncture and isolation of the causal germ. Despite adapted antibiotics and immobilization with traction-suspension, hip joint destruction could not be prevented and all patients became bedridden. Surgery was therefore undertaken to remove the head and neck and institute local antibiotic treatment. A total hip prosthesis was implanted in all patients. RESULTS: At 2 to 12 years follow-up, all seven patients had nearly normal hip function (all 10 hips). Recurrent infection nevertheless developed in 2 hips, demonstrating the limitations of this technique.
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