Physiotherapy Rehabilitation Following Total Hip Replacement in a Patient with Avascular Necrosis of Femoral Head Secondary to Sickle Cell Anemia: A Case Report

Avascular necrosis (AVN) of the femoral head is a significant complication of sickle cell disease (SCD), often requiring total hip replacement (THR). While surgical outcomes are well-documented, evidence regarding post-operative physiotherapy rehabilitation protocols remains limited. This case involved a 33-year-old male with SCD who complained of hip pain and inability to move them as they used to. Bilateral femoral head AVN followed this on diagnoses. He finally underwent staged bilateral THR on the right side. Oxford Hip Score can assess complete functional impairment at the first visit as 17/48 and LEFS as 69/80. An organised 4-week physiotherapy intervention regime was administered that pointed at pain control, progressive resistance training, gait training and functional reintegration. The protocol was centred on a graded load and hierarchical pattern of exercising. Post-rehabilitation assessment showed significant improvements in functional outcomes (OHS): Austin: limb oedema (43/48), LEFS (12/80) and pain score (10/9 to 10/2). The patient could also go around without another person's assistance and perform daily activities. Therefore, the case provides an example of a well-coordinated approach to physiotherapy that has promising outcomes in cases with AVN caused by SCD after bilateral THR; nevertheless, systemic rehabilitation has to be stressed to enhance the patient’s functional status.