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Abstract
With an increasing number of people immigrating between different countries, sickle
cell disease (SCD) is spreading all over the world. Due to improved health care, the
life span of SCD patients has increased and many of them live to adulthood and middle-age.
Osteonecrosis of the femoral head is one of the most common musculo-skeletal problems
in SCD patients. Once osteonecrosis starts in the femoral head, it can progress from
early to late stages in just a few years. Managing osteonecrosis of the femoral head
in young-adults is a challenging problem and, in many situations, it requires major
surgical procedures. In the early stages of the disease it is advisable to treat it
by femoral head preserving procedures. In advanced stages, hip replacement arthroplasty
(HPA) is indicated. In SCD patients, the incidence of operative complications and
failure rates are higher than that for osteonecrosis due to other causes. Understanding
the problems of SCD patients; appropriate diagnosis, prognosis, implications of the
procedure performed and taking the necessary precautions, can reduce the complications
and delay the failure of surgical procedures.