Sickle cell disease (SCD) is a hereditary hemoglobinopathy characterized by the production of abnormal haemoglobin, leading to the formation of sickle-shaped red blood cells. These cells cause intermittent vascular occlusion, resulting in tissue ischemia and a range of systemic complications. Among the most prevalent skeletal manifestations of SCD is avascular necrosis (AVN) of the femoral head, which often necessitates surgical intervention. Total hip arthroplasty (THA) has emerged as a critical treatment option for these patients; however, the procedure presents unique technical challenges and perioperative considerations due to the underlying pathophysiology of SCD. This article examines the pathological mechanisms of sickle cell disease, highlights the complexities of THA in this population, and discusses strategies to optimize outcomes in the management of SCD-related AVN.

Hatem Hamed Alharbi is a distinguished orthopedic consultant surgeon at King Fahad Armed Forces Hospital in Jeddah, Saudi Arabia. He is a fellow of the Royal College of Physicians and Surgeons of Canada, with clinical subspecialties and advanced fellowship training in lower limb reconstruction. He earned his MBChB in medicine from King Abdulaziz University in 1999. He then pursued further specialization at McMaster University, where he completed his FRCS(C) in orthopaedic surgery in 2009 and a clinical fellowship in lower limb reconstruction in 2010. His expertise and commitment to advancing orthopedic care make him a prominent figure in his field.