Avascular necrosis of the femoral head associated with haemoglobinopathy.

The clinical and X-ray records of 22 patients with avascular necrosis of the femoral head associated with haemoglobinopathy seen at the University College Hospital, Ibadan over the period 1968-1973 were analysed retrospectively. There were 14 cases of necrosis of the femoral head in sickle cell haemoglobin C disease (SC disease) and four cases each in homozygous S disease (SS disease) and sickle cell trait (AS trait). The sex incidence was nearly equal. The mean age of the patients when first seen was 13.7 years (range 7-27 years). Radiologically, two types of lesions were seen: Perthes-like necrosis and severe hip deformity. No case of osteochondritis dissecans type of lesion was encountered. All patients were treated conservatively with analgesics and no weight bearing, with symptomatic improvement in all but generally unsatisfactory results as regards reconstitution of the femoral head.