Iranian Journal of Orthopedic Surgery

Abstract Sickle cell disease (SCD), often leads to skeletal complications such as avascular necrosis (AVN) of the femoral head, osteoporosis, fractures, and infections. Despite joint-preserving surgeries, many SCD patients require total hip arthroplasty (THA). However, THA carries significant risks for these patients, including hypoxia and vascular. This case report describes a 29-year-old female with SCD who presented with recurrent hip pain after a previous surgery was canceled due to a sickle cell crisis. Physical examination revealed restricted hip motion, and imaging confirmed AVN of the right femoral head. After a thorough hematology consultation, uncemented THA was performed. The surgery was uneventful, with minimal blood loss and no need for transfusion. The patient recovered well and was stable at her first follow-up. THA is common in SCD patients due to the high incidence of femoral head osteonecrosis, but they face higher risks of postoperative complications. Therefore, careful preoperative planning and coordination among surgical, anesthetic, and hematology teams are crucial for optimizing outcomes.