An overview of pathophysiology and treatment options of osteonecrosis of femoral head in sickle cell disease

Osteonecrosis of the femoral head (ONFH) is the most prevalent musculoskeletal pathologic manifestation of sickle cell disease (SCD) resulting in an osteonecrotic event. This review aimed to summarize mechanisms involved in pathophysiology of ONFH and treatment options available in Saudi Arabia to t...

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Bibliographic Details
Published in:Saudi medical journal 2022-11, Vol.43 (11), p.1192-1199
Main Author: Al-Otaibi, Mohammed L
Format: Article
Language:English
Subjects:
Bone diseases
Bones
Complications and side effects
Gangrene
Morphology
Necrosis
Pathology
Pathophysiology
Sickle cell anemia
Sickle cell disease
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Summary:Osteonecrosis of the femoral head (ONFH) is the most prevalent musculoskeletal pathologic manifestation of sickle cell disease (SCD) resulting in an osteonecrotic event. This review aimed to summarize mechanisms involved in pathophysiology of ONFH and treatment options available in Saudi Arabia to treat SCD patients with complication of osteonecrotic event. The pathophysiology of ONFH include genetic and micro particles involvement. The progression of osteonecrosis involves reduced levels of bioactive compounds in peripheral blood mononuclear cells and elevated [CD4.sup.+]T circulating levels to stimulate pro-inflammatory cytokines contributing to inflammation at target site. Initial treatment approach is pharmacological agents use to mitigate risk. Further, bone morphogenetic protein stimulation initiate bone formation and treatment can be improved with the use of bone morphogenetic protein, total hip arthroplasty and cell therapies. This review provides baseline information for future studies to be carried out in Saudi Arabia to improve treatment options in SCD patients with ONFH. Keywords: sickle cell disease, osteonecrosis of the femoral head, pathophysiology, treatment options, hyperbaric oxygen, cell therapies, core decompression, bone grafting, osteotomy, total hip arthroplasty [phrase omitted]
ISSN:0379-5284
1658-3175
DOI:10.15537/smj.2022.43.11.20220429