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Sickle cell trait in orthopaedic surgery: A real issue or just a bogeyman

Francesco Pisanu, Gianfilippo Caggiari*, Sebastiano Ortu, Maria Luisa Satta, Carlo Doria

Background: Sickle cell disease is a hereditary blood disease characterized by the production of abnormal haemoglobin. HbS precipitates in the red cells under specific circumstances. The sickle cell trait (SCT), long considered an asymptomatic, condition, is instead associated with several complications. SC carriers are under physical stress more predisposed to develop certain morbidities such as pulmonary embolism, deep vein thrombosis, rhabdomyolysis and heat-associated collapse. An intense physical stress associated with the HbS carrier condition can lead to sudden death. Major surgeries, and especially orthopedic surgery, are physically stressful events. A targeted screening of high-risk patients could be useful for several advantages.