Total Hip Arthroplasty in Sickle Cell Disease: Implications and Challenges

Sickle cell disease (SCD) is one of the most common inherited hemoglobinopathies in the West African sub-region and is frequently complicated by musculoskeletal manifestations, especially avascular necrosis (AVN) of the femoral head.This complication can progress to femoral head collapse and secondary osteoarthritis, leaving total hip arthroplasty (THA) as the only definitive solution.However, THA in patients with SCD is fraught with unique challenges: altered bone morphology, poor bone quality, increased risk of intraoperative fracture, susceptibility to infection, and a higher likelihood of revision compared to standard populations.This review synthesizes the available literature on the clinical indications, perioperative optimization, surgical considerations, implant selection, and outcomes of THA in SCD.It highlights both the advances achieved and the persistent barriers to optimal outcomes, particularly in resource-limited regions where the disease burden is greatest.While complications remain more frequent than in the general population, THA in SCD continues to demonstrate significant pain relief, improved function, and enhanced quality of life when performed in specialized settings with multidisciplinary care.