Doctors at Indraprastha Apollo Hospitals here claim to have successfully performed “a very risky bilateral Total Hip Replacement (THR) surgery” on a Nigerian national suffering from sickle cell disease (SCD), bringing the patient out of an immobile state to one in which she can walk and lead a normal life.
“While the operation was performed in February this year, the patient has now, after a series of follow-ups at the hospital, been declared fit. The patient came to us with a rare case of bony Ankylosis of both hip joints, secondary to sickle cell disease,” said senior Orthopaedics consultant Yash Gulati.
Dr. Gulati said: “Twenty-nine-year-old Ayomide Oladunniolajide was suffering from SCD since birth. It is an inherited (genetic) disorder where the red blood cells assume an abnormal shape of a sickle under certain conditions. She had severe stiffness in both her hip joints owing to complications from SCD. Over time her condition worsened and for the past 10 years she had a complete loss of motion in both hips.”
“She was unable to move the muscles of her legs due to which she had difficulty in maintaining perineal hygiene. The patient was on steroid treatment for SCD in her native country and was required to wear a bilateral hip spica. Despite that, her condition continued to deteriorate. She was then brought to Indraprastha Apollo Hospitals and admitted on February 9,” Dr. Gulati said.
The doctors evaluated her and recommended replacement of both the hips to cure her condition. The patient was then put under serial radiological studies which revealed that she suffered from severe bony Ankylosis of the hip, a condition wherein bones of a joint unite by proliferation of bone cells resulting in complete immobility.
Hospital authorities said on Wednesday, “After further examination including spine X-ray and haematological study, the patient was taken for a bilateral THR in a staged manner at an interval of one month. The team of doctors and surgeons (while) operating on February 12 faced a few complications due to irregular movement of the muscle on account of which it was not possible to insert a narrow tube into the body cavity for her preoperatively.”
“To overcome these complications, the surgery was successfully performed utilising the modified harding lateral approach. Over the following weeks, the patient had improvement of hip flexion bilaterally permitting easy functional sitting. Post-operative physiotherapy resulted in great improvement in her general physical activity. Over time, Ayomide was able to regain mobility in her hips and was able to walk and perform other physical activity without much difficulty,” said Dr. Gulati.
Sharing his experience of treating Ayomide, Dr. Gulati said: “Sickle cell disorder is a complex blood disorder and most people suffering from it die very young. The disorder is highly prevalent in Nigeria with around 2 per cent of newborns affected by the disease. Ayomide came to us in an immobile state and was not able to maintain personal hygiene. The surgery has helped her regain her ability to walk and lead a normal life.”