Perioperative care for patients with sickle cell who are undergoing total hip replacement as treatment for osteonecrosis.

Sickle cell disease, which is characterized by chronic hemolytic anemia, is prevalent in the United States. In addition to the profound multisystem effects of vasoocclusion associated with sickle cell disease, osteonecrosis of the femoral head classically develops at an early age. Because of advanced medical technology and new treatment modalities, patients with sickle cell disease are living longer. More adults with this genetic disease are becoming candidates for total hip arthroplasty. This article describes the pathophysiology of sickle cell anemia, explains the process of osteonecrosis, and discusses total hip arthroplasty in this unique patient population.