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Erythrocyte Exchange Transfusion Enabling Simultaneous Bilateral Total Hip Arthroplasty by a direct anterior approach in a Young Patient with Sickle Cell Disease

Year: 2025

Type: article

Abstract: Sickle cell disease (SCD) is a known risk factor for femoral head osteonecrosis, often leading to early joint degeneration. We report a 17-year-old male with homozygous SCD and bilateral femoral head collapse who underwent simultaneous bilateral total hip arthroplasty through a direct anterior approach. Preoperative optimization included erythrocyte exchange transfusion effectively reducing hemoglobin S from 76% to 26%. The procedure was completed without complications, and the patient recovered uneventfully, with no sickling crises or acute chest syndrome. Cemented implants were used due to poor bone quality. The patient regained full, pain-free ambulation by three months. This case supports the safety and feasibility of simultaneous bilateral total hip arthroplasty in selected SCD patients when preceded by targeted erythrocyte exchange transfusion and managed by a multidisciplinary team.

Source: Arthroplasty Today

DOI: 10.1016/j.artd.2025.101909

Authors: Enrique Alberto Vargas Meouchi, Ricard Llovera González-Adrio, David Beneitez Pastor, Veronica Pons, Marta Garcia Bernal, Victor Manuel Barro Ojeda

Institutions: Universitat Autònoma de Barcelona, Vall d'Hebron Hospital Universitari

Language: English

Topic: Orthopaedic implants and arthroplasty

Subfield: Surgery

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $2,500