Background : Humeral head osteonecrosis is a frequent complication of Sickle Cell Disease (SCD). Little is known about shoulder arthroplasty indications and results in these patients. The aim of this retrospective review is to compare the actual indications and results for SCD to a literature review.
Methods : All shoulder arthroplasties performed on SCD patients between 2016 and 2022 have been evaluated. 17 shoulders in 15 patients were followed up for 2.5 years. Indications, functional and radiological results, and complications were compared to a literature review.
Results : The Constant score significantly improved by 35 points (p =0.016). Patients were finally satisfied with a mean SSV evaluation at 72%. Post-operative complications due to SCD were frequent. There was a bilateral dramatic reverse prosthesis loosening in a patient with severe bone sclerosis due to necrosis. The use of pyrocarbon hemi-arthroplasty is promising and was never described in the literature for SCD shoulder osteonecrosis.
Discussion : Shoulder arthroplasty for collapse humeral head in SCD patients should be considered because of the significant functional improvement that can be obtained. Patients with SCD should be operated in a center with specialized surgeons surrounded by heamatologists to prevent specific complications.
Sébastien ZILBER*, Valentin BAUDRY, and Victor HOUSSET