Musculoskeletal Complications of Sickle Cell Anaemia and Their Management Approaches in Makurdi, Nigeria

Background: Musculoskeletal complications are responsible for up to 80% of indications for presentation to the hospital by sicklers during their life time. It is important to know when to expect the complications and the treatment options available.

Methods: A retrospective study was conducted involving all sickle cell anaemia patients treated between June 2012 and May 2017 at Benue State University Teaching Hospital (BSUTH), Makurdi, Nigeria. The data collected included age, sex, complications, anatomic site, stage of disease and treatment. Data obtained were analyzed using the software Statistical Package for Social Sciences for Windows version 15.0 (SPSS, Inc; Chicago, Illinois) and presented as frequencies (%) and mean values (SD) as appropriate, P < 0.05 was taken as statistically significant.

Results: Thirty one out of 85 sicklers presented with 53 musculoskeletal complications giving a prevalence rate of 36.4%.There were 18 males and 13 females with mean age of 14.2±1.03 years. Those ≤ 20 years had more complications than those 21 years and above, P=0.0001. The femur was involved in 20(37.7%) and avascular necrosis 17(20.1%) was the most common complication followed by septic arthritis 13(15.3%) and chronic osteomyelitis 8(9.4%). The mean Haemoglobin concentration 7.5±0.5 mg/dl of the patients with AVN was higher than those without it, P=0.02. Conservative treatment was employed in treatment of 40(75.7%) of the complications while others had arthrotomies and arthroplasties.

Conclusion: Avascular necrosis, osteomyelitis and septic arthritis are the most common orthopaedic complication among sicklers in Makurdi. They occur predominantly in the younger age group and many are amenable to conservative treatment.