Avaliação funcional de pacientes com osteonecrose da cabeça femoral secundária à doença falciforme

Abstract

Functional evaluation of patients with osteonecrosis of the femoral head secondary to sickle cell disease. Introduction: Sickle cell disease (SCD) is the most common hereditary hematological disease in the world. Due to the significant number of patients with this disease, it is a public health problem in Brazil, mainly in Bahia, due to the high percentage of racial miscegenation. The clinical picture of sickle-cell disease (SCD) is due to two main phenomena, which are vascular occlusion by red blood cells followed by infarction in the various tissues and organs and the phenomena of chronic hemolysis. Among the other osseous manifestations of SCD (osteomyelitis, synovial articular disease or hemochromatosis) one of the most frequent and serious is osteonecrosis. The exact prevalence of femoral head osteonecrosis (FHO) is unknown. The incidence of FHO is 10% to 30% of the population with SCD and often has bilateral hip involvement, predominating in young adults. FHO usually results in severe pain, limitation of joint amplitude, and disturbance of the spine, which may lead to permanent disability. Objectives: Functional evaluation of patients with hip osteonecrosis secondary to sickle cell disease. Methodology: This is a cross-sectional study in order to evaluate the role of patients with FHO secondary to SCD. The data were collected through the data collection form and the application of the Lequesne questionnaire. Results: Twenty-four patients were interviewed, ranging from 12 to 56 years, 14 (58.3%) women and 10 (41.7%) men. Regarding the hip side with osteonecrosis, we observed 16 cases (66.6%) with bilateral involvement of the hip joint, 7 (29.2%) on the isolated right side and 1 (4.2%) on the isolated left side. After applying the questionnaire, 13 (54.2%) people were classified as extremely severe, 2 (8.3%) very severe, 3 (12.5%) severe, 3 (12.5%) moderate and the other 3 (12.5) as little affected. Conclusion: The demographic and hip data affected by the ONCF corroborate with those found in the literature and data from the epidemiology of ONCF in DF are different from those in the literature for ONCF of other etiologies. The patients in the present study had poor functional results.