TY - JOUR
T1 - Hemoglobinopathy is Associated With Total Hip Arthroplasty Indication Even Beyond Sickle Cell Anemia
AU - Rakutt, Maxwell J.
AU - Bracey, Daniel N.
AU - Cohen-Rosenblum, Anna
AU - Sculco, Peter K.
AU - Sabatini, Franco M.
AU - Jacobs, Cale A.
AU - Duncan, Stephen T.
AU - Landy, David C.
N1 - Publisher Copyright:
© 2022 The Authors
PY - 2023/2
Y1 - 2023/2
N2 - Background: The extent to which hemoglobinopathies other than sickle anemia (HbSS) are associated with hip osteonecrosis is unknown. Sickle cell trait (HbS), hemoglobin SC (HbSC), and sickle/β-thalassemia (HbSβTh) may also predispose to osteonecrosis of the femoral head (ONFH). We sought to compare the distributions of indications for a total hip arthroplasty (THA) in patients with and without specific hemoglobinopathies. Methods: PearlDiver, an administrative claims database, was used to identify 384,401 patients aged 18 years or older undergoing a THA not for fracture from 2010 to 2020, with patients grouped by diagnosis code (HbSS N = 210, HbSC N = 196, HbSβTh N = 129, HbS N = 356). β-Thalassemia minor (N = 142) acted as a negative control, and patients without hemoglobinopathy as a comparison group (N = 383,368). The proportion of patients with ONFH was compared to patients without it by hemoglobinopathy groups using chi-squared tests before and after matching on age, sex, Elixhauser Comorbidity Index, and tobacco use. Results: The proportion of patients with ONFH as the indication for THA was higher among those with HbSS (59%, P <.001), HbSC (80%, P <.001), HbSβTh (77%, P <.001), and HbS (19%, P <.001) but not with β-thalassemia minor (9%, P =.6) than the proportion of patients without hemoglobinopathy (8%). After matching, the proportion of patients with ONFH remained higher among those with HbSS (59% vs 21%, P <.001), HbSC (80% vs 34%, P <.001), HbSβTh (77% vs 26%, P <.001), and HbS (19% vs 12%, P <.001). Conclusions: Hemoglobinopathies beyond sickle cell anemia were strongly associated with having osteonecrosis as the indication for THA. Further research is needed to confirm whether this modifies THA outcomes.
AB - Background: The extent to which hemoglobinopathies other than sickle anemia (HbSS) are associated with hip osteonecrosis is unknown. Sickle cell trait (HbS), hemoglobin SC (HbSC), and sickle/β-thalassemia (HbSβTh) may also predispose to osteonecrosis of the femoral head (ONFH). We sought to compare the distributions of indications for a total hip arthroplasty (THA) in patients with and without specific hemoglobinopathies. Methods: PearlDiver, an administrative claims database, was used to identify 384,401 patients aged 18 years or older undergoing a THA not for fracture from 2010 to 2020, with patients grouped by diagnosis code (HbSS N = 210, HbSC N = 196, HbSβTh N = 129, HbS N = 356). β-Thalassemia minor (N = 142) acted as a negative control, and patients without hemoglobinopathy as a comparison group (N = 383,368). The proportion of patients with ONFH was compared to patients without it by hemoglobinopathy groups using chi-squared tests before and after matching on age, sex, Elixhauser Comorbidity Index, and tobacco use. Results: The proportion of patients with ONFH as the indication for THA was higher among those with HbSS (59%, P <.001), HbSC (80%, P <.001), HbSβTh (77%, P <.001), and HbS (19%, P <.001) but not with β-thalassemia minor (9%, P =.6) than the proportion of patients without hemoglobinopathy (8%). After matching, the proportion of patients with ONFH remained higher among those with HbSS (59% vs 21%, P <.001), HbSC (80% vs 34%, P <.001), HbSβTh (77% vs 26%, P <.001), and HbS (19% vs 12%, P <.001). Conclusions: Hemoglobinopathies beyond sickle cell anemia were strongly associated with having osteonecrosis as the indication for THA. Further research is needed to confirm whether this modifies THA outcomes.
KW - Hemoglobinopathy
KW - Osteoarthritis
KW - Osteonecrosis
KW - Sickle cell disease
KW - Total hip arthroplasty
UR - http://www.scopus.com/inward/record.url?scp=85147219940&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85147219940&partnerID=8YFLogxK
U2 - 10.1016/j.artd.2022.10.012
DO - 10.1016/j.artd.2022.10.012
M3 - Article
AN - SCOPUS:85147219940
VL - 19
JO - Arthroplasty Today
JF - Arthroplasty Today
M1 - 101062
ER -