Research on 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.