Does sickle cell disease raise the chances that patients undergoing a knee replacement may have adverse surgical outcomes? According to a report published by Viswanathan et al in Archives of Orthopaedic and Trauma Surgery, patients with sickle cell disease were more likely to have an extended hospital stay, incur greater health-care costs, and be discharged to a step-down health-care facility following their initial hospitalization compared to patients without sickle cell disease. Additionally, they were more likely to develop a host of postsurgical conditions, including acute chest syndrome (nearly 25% of enrolled sickle cell disease patients developed this complication), pain crisis (nearly 21%), and splenic sequestration crisis (nearly 25%); and they were more likely to experience acute renal failure, a need for blood transfusions, and deep venous thrombosis.
In a companion press release on the findings released by UT Southwestern Medical Center, senior study author Senthil Sambandam, MD, Assistant Professor of Orthopaedic Surgery, emphasized, “Sickle cell patients undergoing total knee replacement need a multidisciplinary approach and may be better served in specialized centers capable of caring for these complex medical patients…. These patients have a higher risk of postoperative complications requiring the involvement of various specialists including nephrologists, pulmonologists, and hematologists.”