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Ankylosis of the hips and knees due to sickle cell disease.

Al Elayan SS, Al Hamdan A - F1000Res (2012)

Bottom Line: The patient's hemoglobin S decreased to levels below 30% by exchange transfusion.Bilateral total hip replacement, as well as unilateral total knee replacement, was carried out to improve his level of function.These complications were successfully managed and the patient was able to move and transfer using a wheel chair.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopedics, Prince Sultan Military Medical City, Riyadh, 11612, Saudi Arabia.

ABSTRACT
This is a case report of a 29-year-old Saudi male with sickle cell disease (SCD) with severe stiffness of his joints, mainly both knees and hips, secondary to complications of SCD. He was severely crippled: unable to sit, stand or walk, and was bedridden for 8 years when he was presented to us. Radiographs showed fusion of both knees and hips. There was no evidence of active osteomyelitis by Gallium scan. The patient's hemoglobin S decreased to levels below 30% by exchange transfusion. Bilateral total hip replacement, as well as unilateral total knee replacement, was carried out to improve his level of function. There is only one reported case of such severe and multiple joint complications in a single patient suffering from SCD. The increased life expectancy that medical advances have offered to the sickle-cell patients has led to the appearance of sickle-cell-related complications, which were previously only seen rarely. These complications were successfully managed and the patient was able to move and transfer using a wheel chair.

No MeSH data available.


Related in: MedlinePlus

X-ray of left knee post TKR.
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f4: X-ray of left knee post TKR.

Mentions: Left total knee replacement (TKR) was performed one month after the THR (Figure 4). Intraoperatively, the bone quality was noted to be severely deficient. The quadriceps muscle was adherent to the femur and atrophied; therefore, V-Y quadricepsplasty was done. Soft tissue was mobilized carefully around the joint prior to component insertion. Intraoperatively, knee flexion approached 50°. Post-left-TKR rehabilitation was severely restricted secondary to poor bone quality. This prevented adequate ROM exercises and function, and ROM gains at the knee were minimal. Poor bone quality also limited the ability for the patient to progress to functional lower extremity weight-bearing activities. Postoperatively, rehabilitation, patient education, transfer training and functional rehabilitation were carried out. This allowed the patient to transfer safely and independently from bed to wheel chair without much pain, and improved the quality of life by changing the patient’s functional ability and allowing the freedom to mobilize independently with a wheelchair.


Ankylosis of the hips and knees due to sickle cell disease.

Al Elayan SS, Al Hamdan A - F1000Res (2012)

X-ray of left knee post TKR.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC3814913&req=5

f4: X-ray of left knee post TKR.
Mentions: Left total knee replacement (TKR) was performed one month after the THR (Figure 4). Intraoperatively, the bone quality was noted to be severely deficient. The quadriceps muscle was adherent to the femur and atrophied; therefore, V-Y quadricepsplasty was done. Soft tissue was mobilized carefully around the joint prior to component insertion. Intraoperatively, knee flexion approached 50°. Post-left-TKR rehabilitation was severely restricted secondary to poor bone quality. This prevented adequate ROM exercises and function, and ROM gains at the knee were minimal. Poor bone quality also limited the ability for the patient to progress to functional lower extremity weight-bearing activities. Postoperatively, rehabilitation, patient education, transfer training and functional rehabilitation were carried out. This allowed the patient to transfer safely and independently from bed to wheel chair without much pain, and improved the quality of life by changing the patient’s functional ability and allowing the freedom to mobilize independently with a wheelchair.

Bottom Line: The patient's hemoglobin S decreased to levels below 30% by exchange transfusion.Bilateral total hip replacement, as well as unilateral total knee replacement, was carried out to improve his level of function.These complications were successfully managed and the patient was able to move and transfer using a wheel chair.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopedics, Prince Sultan Military Medical City, Riyadh, 11612, Saudi Arabia.

ABSTRACT
This is a case report of a 29-year-old Saudi male with sickle cell disease (SCD) with severe stiffness of his joints, mainly both knees and hips, secondary to complications of SCD. He was severely crippled: unable to sit, stand or walk, and was bedridden for 8 years when he was presented to us. Radiographs showed fusion of both knees and hips. There was no evidence of active osteomyelitis by Gallium scan. The patient's hemoglobin S decreased to levels below 30% by exchange transfusion. Bilateral total hip replacement, as well as unilateral total knee replacement, was carried out to improve his level of function. There is only one reported case of such severe and multiple joint complications in a single patient suffering from SCD. The increased life expectancy that medical advances have offered to the sickle-cell patients has led to the appearance of sickle-cell-related complications, which were previously only seen rarely. These complications were successfully managed and the patient was able to move and transfer using a wheel chair.

No MeSH data available.


Related in: MedlinePlus