Can osteonecrosis of the femoral head be treated in the setting of Sickle Cell Disease?
Treatment is very unsatisfactory. The patient may be put on non-weight-bearing status in an attempt to allow revascularization and prevent collapse of the affected bone, although this is rarely effective. An orthopedic surgeon should be consulted promptly. Core decompression of the femoral head may be attempted in early cases. Prosthetic joint replacement is often the treatment when joint damage is advanced, although results are suboptimal. In one series, 19% of total hip replacements for avascular necrosis of the femoral head in SCD required revision within 5 years. Perioperative worsening of SCD is common.
