Treatment ischemic necrosis of the femoral head with vascularized iliac graft in young patients with sickle-cell disease.

OBJECTIVE

To investigate the therapeutic effects of the vascularized iliac graft for ischemic necrosis of the femoral head in Niger young patients with sickle cell disease.

METHODS

From November 1998 to Apirl 2001, 12 patients(5 males and 7 females, aging 11-22 years) with sickle cell disease suffered from ischemic necrosis of the femoral head in 14 hips. The lesion was on one hip in 10 patients and on bilateral hip in 2 patients. Necrosis was classified as Ficat Stage III-IV in all patients. Twelve hips in 12 patients were treated with vascularized iliac graft in Maradi Province Hospital of Niger. The effects were evaluated on the basis of the Harris hip score and radiological examination.

RESULTS

The patients were followed up 24-30 months after operation(27.4 months on average). The clinical results were satisfactory though no radiological evidence of improvement was noted. The mean Harris hip score increased from 75 points to 90 points. Pain relief and hip function improvement were achieved in all patients. No patients needed revision during short-term follow-up of 24-30 months.

CONCLUSION

The method is recommendation for treatment of ischemic necrosis of the femoral head in the Ficat Stages III-IV in young patients with sickle cell disease for pain relief and restoration of hip joint function. This procedure may prolong the timing and acting of total hip arthroplasty.