Osteonecrosis in sickle cell disease: Contemporary orthopaedic practice and outcomes across African healthcare settings

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Table 1

Overview of study characteristics.

Author	Year	Study design	No. of AVN cases	Disease stage (Ficat)	Bone(s)/joint(s) affected	Management approach
Iwegbu and Fleming [15]	1985	Case Series	29	I; II; 8; III; 16; IV; 5	Femoral head	NA
Ben Dridi et al. [16]	1987	Case Series	13	NA	Femoral head, humeral head	NA
Ugbeye et al. [17]	2020	Case Series	56	I; II; III; IV; 68	Femoral head	Arthroplasty
Katchy et al. [18]	2018	Case series	21	NA	Femoral head	Arthroplasty
Ekere et al. [19]	2008	Case series	2	I; II; III; 1; IV; 1	Femoral head	Arthroplasty
Ebong et al. [20]	1985	Case series	75	NA	Femoral head	Physical immobilization
						Femoral osteotomy
Ugbeye et al. [21]	2024	Case report	1	I; II; III; IV; 2	Femoral head	Arthroplasty
Agbeko et al. [22]	2024	Cross-sectional	54	I; II; 23; III; 8; IV; 23	Femoral head	NA
Onyemaechi et al. [23]	2011	Case series	12	I; II; 2; III; 7; IV; 3	Femoral head	Joint offloading Femoral osteotomy
						Arthroplasty
Lumbardo et al. [24]	2020	Case series	3	I; II; III; IV; 3	Femoral head	Arthroplasty
Manfroni et al. [25]	2020	Case report	1	NA	Femoral head	Arthroplasty
Akinyoola et al. [26]	2007	Case series	66	II-12; III-14; IV; 40	Femoral head	NA
Knox-Macaulay [27]	1983	Prospective cohort	9	NA	Femoral head	NA
Bokolombe et al. [28]	2013	Case report	1	I; II; 1; III; IV	Femoral head	Arthroplasty
Alonge et al. [29]	2004	Case series	5	I; II; III; IV; 4	Femoral head	Arthroplasty

Balogun et al. [7]	2010	Prospective cohort	28	I; II – 1; III – 7; IV – 20	Femoral head	NA

Akakpo-Numado et al. [30]	2008	Case Series	14	I; II; III – 8; IV – 6	Femoral head	Femoral osteotomy
Mouba et al. [31]	2011	Case Series	22	I; II; III – 22; IV	Femoral head	Traction device
						Cast immobilization
						Offloading orthoses
						Physical therapy
Bennis et al. [32]	2020	Case report	1	NA	Femur shaft	Joint offloading
N'Dri et al. [33]	2000	Cross-sectional	34	III – 34	Femoral head	NA
Akinyoola et al. [34]	2008	Case control	25	I – 1; II – 7; III – 4; IV – 13	Femoral head	NA
Ouerderni et al. [35]	2023	Case Control	41	I – 7; II – 12; III – 22; IV	Femoral head	NA
Wu et al. [36]	2005	Case series	14	NA	Femoral head	Iliac bone grafting
Ebong [37]	1976	Case series	22	NA	Femoral head	Hip spica immobilization
Sene et al. [38]	2009	Case Series	38	I; II; III – 10; IV – 28	Femoral head	Arthroplasty
Ndugwa [39]	1992	Case Series	47	I; II; III; IV – 47	Femoral head	Traction device
						Cast immobilization
Ofakunrin et al. [40]	2021	Cross-sectional study	38	I; II – 8; III – 9; IV – 16	Femoral head	NA
Bahebeck et al. [41]	2004	Prospective cohort	35	I – 6; II – 4; III – 11; IV – 4	Femoral head, lumbar spine, humeral head, talar body	Core decompression
						Arthroplasty
						Arthrodesis
Mosaku et al. [42]	2015	Cross-sectional study	13	NA	NA	NA
Alabi et al. [43]	2021	Prospective cohort	27	I; II; III; IV – 38	Femoral head	Arthroplasty
						Adductor tenotomy
Bamgbade et al. [44]	2021	Prospective cohort	14	Steinberg stage VI – 14^a	Femoral head	Arthroplasty
Lawal et al. [45]	2017	Prospective cohort	18	I; II; III – 18; IV	Femoral head	Arthroplasty

^aThe Steinberg classification was adopted in this study. NA – Not available or Not applicable.

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