The short answer
In sickle cell disease the sickled cells can block the small vessels that feed the ball of the hip joint, so the bone dies and slowly collapses: this is avascular necrosis. Early on it may be managed with painkillers, protected walking and physiotherapy, but once the ball has collapsed and pain limits daily life a total hip replacement is usually the treatment that restores walking. Surgery in sickle cell needs careful planning between the orthopaedic surgeon and a haematologist, usually including a blood transfusion plan.
Book a hip replacement assessment, from ₦5,500,000Medically reviewed by Dr Debo Odulana, Founder and Chief Executive, Mezo. Last reviewed . This page is general information, not a diagnosis. Care is decided with you after an examination.
Why sickle cell affects the hip
The ball at the top of the thigh bone (the femoral head) has a fragile blood supply. In sickle cell disease, repeated blockage of small vessels starves it of blood. The bone weakens, cracks under the load of walking and loses its round shape. Hip avascular necrosis is a common complication of sickle cell disease and it often starts in teenagers and young adults, sometimes in both hips.
Signs it is the hip and not just a crisis
A painful crisis comes and goes. Avascular necrosis pain tends to stay and get worse over months. Look out for:
- Pain in the groin, buttock or front of the thigh, sometimes felt in the knee
- A limp, or pain on standing up and on the first steps
- Difficulty putting on shoes, cutting toenails or sitting cross-legged
- Pain at night or at rest as it progresses
How it is diagnosed
An X-ray shows the later stages: flattening and collapse of the ball. In the early stage the X-ray can look normal, and an MRI scan picks it up sooner. Ask for both hips to be checked, because the other side is often affected too. The stage on imaging guides what is offered.
What can be tried before a replacement
When the ball has not yet collapsed, the aim is to protect it: painkillers, crutches to take weight off for a period, and physiotherapy to keep the muscles strong and the hip moving. In some early cases a surgeon may discuss a smaller procedure to relieve pressure inside the bone. Once the ball has collapsed and the joint is worn, these do not reverse it, and a hip replacement is usually the option that gives back a pain-free walk.
Why the surgery needs extra planning
A hip replacement in sickle cell disease carries more risk than in someone without it: a painful crisis or acute chest syndrome around the operation, infection, and more blood loss. These risks are managed, not ignored. Expect your surgeon to work with a haematologist, check your haemoglobin and blood counts, and plan a transfusion before surgery if it is needed. Staying warm, well hydrated, well oxygenated and pain-controlled after the operation all lower the chance of a crisis.
Because many people with sickle cell are young when they need a new hip, ask about how long the implant is expected to last and what a future revision would involve. Your surgeon will tell you what applies to you.
Recovery
Most people stand and walk with a frame or crutches within a day or two, then build up with physiotherapy over the following weeks. Keep taking your usual sickle cell medicines unless the team changes them, drink plenty of water, and report fever, chest pain or breathlessness straight away.
What it costs on Mezo
Same primary joint replacement case rate as the knee.
Common questions
I am only 25 with sickle cell. Can I have a hip replacement?
Yes, age does not rule it out. Young people with collapsed hips from sickle cell often need one to walk without pain. The surgeon will talk through implant wear and the chance of a future revision with you.
Will I need blood before the operation?
Many people with sickle cell do, to lower the risk of a crisis around surgery. Your haematologist and surgeon decide together based on your blood counts and history.
Can avascular necrosis heal by itself?
Very early disease can sometimes settle if the hip is protected, but once the bone has collapsed it does not grow back into shape. That is why early assessment matters.
How much is a hip replacement on Mezo?
A total hip replacement is from ₦5,500,000. For sickle cell, the written all-in quote after assessment sets out any extra blood or monitoring the plan needs.
When is hip pain an emergency?
Go to an emergency department the same day if you have fever with a hot, very painful joint, chest pain, breathlessness, or sudden weakness. These can be signs of infection, acute chest syndrome or stroke.
The procedures
Related health guides
More patient guides
Sources and further reading
The guidelines and patient information this page is checked against. Care in Nigeria follows the same evidence; what differs is the price and where it is done.
- Sickle cell disease. NHS. Patient information.
- Hip replacement. NHS. Patient information.
Links last checked 22 October 2026.
Medical disclaimer: This guide is general information and does not replace advice from your own doctor. Where your centre's instructions differ from this guide, follow theirs.