Comparison of Mortality and Complications After Total Hip Arthroplasty in Patients with Sickle Cell Disease: A Retrospective Match-Controlled Study from Türkiye

Objective: Sickle cell disease (SCD) is a well-recognized cause of osteonecrosis of the femoral head, and total hip arthroplasty (THA) in these patients is associated with higher complication rates. Because SCD is rare in the general population, large-scale studies are limited. This study aimed to evaluate complications and mortality after THA in patients with SCD. Materials and Methods: Data from the national e-health database of Türkiye (e-Nabız) were used to identify 138 patients with SCD who underwent primary THA between 2016 and 2022. These patients were matched by age, sex, and Charlson Comorbidity Index score with 552 non-SCD patients. The groups were compared for 90-day medical and surgical complications, hospital stay, and mortality. Results: Venous thromboembolism and pneumonia were more frequent in SCD patients (p=0.028 and p=0.005, respectively). The need for blood transfusion was significantly higher in the SCD group (p<0.001). No significant differences were observed in mortality at 7 days or 1, 3, or 12 months (p>0.05 for all). Similarly, there were no differences in 90-day mechanical or infectious complications (p=0.68 and p=0.57). The overall 90-day medical complication rate was higher in the SCD group (13% vs. 6%; p=0.005). The mean duration of hospital stay did not differ between the groups (p=0.35). Conclusion: Patients with SCD who underwent THA had higher rates of venous thromboembolism, pneumonia, and increased transfusion requirements. Preoperative optimization and multidisciplinary perioperative care are essential to reduce these complications.