Wednesday, 23 February 2011

Fw: Treatment Assistance Patient Ms Chidinma from Nigeria

 Dear Ms Chidinma
Patients with sickle cell disease(SS) usually develop avascular necrosis of the ball of hip causing arthritis, pain and shortening of the leg. This complication usually occur in the younger age group as in your case.
Treatment options include using painkillers and physiotherapy till the pain and functional limitation is mild to moderate. Once pain appears even on rest and on minimal movements then Hip replacement surgery can be considered.
Hip replacement surgery works wonderfully well in relieving pain and restoring function in patients with arthritis and has excellent results. However in patients with sickle cell disease hip replacement has an increased risk of complications as compared to normal population. The complications will include increased possibility of infection and early loosening of the hip implants. These complications can also happen in normal population after total hip replacement but its chances are increased in patients with Sickle cell disease. Having said that we have sucessfully carried out Total hip replacement in patients with sickle cell disease from Nigeria at out hospital previously. Chances of complications after total hip replacement in normal population is 5% and in patients with sickle cell disease it is 15%.
Looking at your xrays it appears that you have badly damaged the hip joint.You should delay the surgery as long as possible but if you have significant pain and discomfort in the hip that is not responding to nonoperative treatment then hip replacement surgery will relieve your symptoms and can be carried at out hospital, provided you are aware of and accept the increased risks of complications associated with such a procedure.
Hospital stay after such a procedure is 1 week approximately and would involve an expenditure of(-----Dr Kousar/Rashmi  please mention the figure). 
Feel free to contact us if  you have any further queries

Dr Jayant Arora
MS(Ortho), DNB(Ortho), MRCS(Edinburgh)
Fellowship in Joint Replacement and Arthroscopic Surgery, Newcastle, UK

Senior Consultant Orthopedics and Joint Replacement Surgeon
Columbia Asia Hospital




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From: Kousar Ali Shah <>
To: 'Jayant Arora' <>
Sent: Tue, February 15, 2011 10:26:00 AM
Subject: FW: Treatment Assistance Patient Ms Chidinma from Nigeria

Dear Dr Jayant

Please suggest.


Thanks & Regards

Dr Kousar A Shah

Chief of Medical Services                            

Columbia Asia Hospital – Palam Vihar

Block-F, Near Gol Chakkar,

Palam Vihar, Gurgaon – 122017,


Telephone:  +91 - 124 - 39898969

Facsimile:     +91 – 124 - 3022022




Please find below the query from the patient.


My name is chidinma and am 25 years genotype is ss,i've sickle cell anemia.since 2008 a developed a hip problem here is a copy of my X-ray.The doctors said that i've Avascular Neurosis(AVN)of Formal Head,limp shortening of 3cm i want to know if i can get  hip replacement. Though the doctors in Nigeria said that there are so many implications based on my genotype that Replacement is not the best option.Please doctor i want to know the best option, implication of the surgery based on my genotype, and also the cost of the surgery.Please will be expecting a response from you .


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