Khadka, TirthendraPande, RajanThapa, Prakash BahadurMishra, Rahul2026-08-102026-08-102026https://hdl.handle.net/20.500.14572/7179Tirthendra Khadka Department of Orthopedics, Bheri Hospital, Nepalgunj, Banke, Nepal. Rajan Pande Department of Medicine, Bheri Hospital, Nepalgunj, Banke, Nepal. Prakash Bahadur Thapa Department of Orthopedics, Bheri Hospital, Nepalgunj, Banke, Nepal. Rahul Mishra Department of Orthopedics, Bheri Hospital, Nepalgunj, Banke, Nepal.Abstract: Introduction: Sickle cell disease is particularly prevalent among the Tharu population of western Nepal. Osteonecrosis of the femoral head is a common and debilitating complication of sickle cell disease, resulting from recurrent vaso-occlusive episodes. The study aimed to determine the functional outcomes and complications following total hip arthroplasty in patients with sickle cell disease-associated osteonecrosis of the femoral head. Methods: A retrospective study was conducted at a tertiary care hospital after ethical clearance (Reference No: 1137/26-01-2026) between January 2019 and June 2025. Medical records of 16 patients who underwent total hip arthroplasty for advanced osteonecrosis of femoral head secondary to sickle cell disease were reviewed. Demographic characteristics, sickle cell genotype, functional outcome and complications were recorded. Functional outcomes were assessed using the Harris Hip Score preoperatively and at 6-month follow-up and were compared using a paired t-test. Results: Among 16 patients (17 hips), the mean Harris Hip Score improved from 46.29±11.92 preoperatively to 86.47±5.96 at 6-month follow-up. The mean age was 40.88±10.31 years. There were 9 (56.25%) females and 7 (43.75%) males. Fourteen patients had homozygous genotype and two had sickle-beta thalassemia. Bilateral hip involvement was observed in 6 (37.50%) patients. Postoperative outcomes were excellent in 6 (35.29%) hips, good in 8 (47.06%), and fair in 3 (17.65%) hips. One superficial wound infection and three acute vaso-occlusive or acute anemic episodes requiring intensive care and transfusion were recorded. Conclusions: Total hip arthroplasty provides significant functional improvement and pain relief in patients with sickle cell disease-associated osteonecrosis of the femoral head, with acceptable complication rates when appropriate perioperative management is provided.en-USarthroplastyhiposteonecrosisreplacementsickle cell diseaseArticle