Abdulwahab M., 19

Abdulwahab is a secondary school student graduate, he is the 3rd among 7 children currently living with his parents in a small populated community some minutes away drive from the main city of Bauchi. Father is a security guard and the mother is a house wife. Other siblings are engaged in some menial jobs to support their parents. The are living in 3 rooms apartment with a pit toilet and they have not been accessible to electricity for a while now. They have a borehole in the middle of the community for everyone to use. Abdulwahab is a sickle cell disease patient that has been on treatment. He has been having on and off bilateral hip pains for the past years and being treated with analgesics only to subside and recur again. On examination, the hip joints are both stiff and tender on attempt at moving them. X-ray investigation showed avascular necrosis of the heads of the femur bilaterally. The bout of pain is often excruciating that it prevents him from carrying out his daily activities. Diagnosis of avascular necrosis of the heads of femur bilaterally was made and patient billed for total hip replacement of the most affected part. Avascular necrosis of the head of the femur is a very severe condition affecting sickle cell disease patients like this one. He is unable to freely move the hip joints which adversely affects his ability to walk, work and sit down. The pain can be severe due to lack of blood flow to the joint. Since the vasculature to the joint has been damaged, the only solution is to replace the entire joint(s) with prosthetic one. This procedure is life changing as it will give him the opportunity to be independent again and better his quality of life. A fellow informed them about Helpster Charity program and they wish to involve their child to have his life changed as well as saved.

Abdul Wahab is a sickle cell disease patients who presented with inability to move his hip joints freely associated with severe pains for more than a year. This has stopped him from walking due to the pain and restrictions. Examination revealed tightly adducted hip joints in a sickle cell disease patient. Plain x-ray showed features in keeping with bilateral avascular necrosis of the heads of the femur. The procedure is quite expensive especially the cost of the prosthesis. On account of that, the patient was worked up for and had total hip replacement on the right. Abdul Wahab did well after the surgery and was discharged seven days postop. He had two pints of blood transfused in the cost of the treatment. He had antibiotics, analgesics as well as physiotherapy and crutches purchased to enable him walk again. He quickly adjusted and was discharged home to continue physiotherapy and follow up.

Murtala is having a severe Avascular Necrosis of the Femur and it is a result of the repeated crisis and has to be surgically corrected by joint replacement. The prognosis for bilateral avascular necrosis of the femoral heads depends largely on the stage at diagnosis and how quickly treatment begins. Early-stage AVN has a better outlook, especially with interventions such as reduced weight-bearing, medications, physiotherapy, and procedures like core decompression. These can slow progression and preserve joint function. However, once the femoral heads start to collapse, the prognosis worsens, leading to chronic pain, severe mobility limitations, and early-onset arthritis. In advanced stages, total hip replacement often becomes necessary for pain relief and functional improvement. Overall, the condition is progressive, but timely management helps improve long-term outcomes and quality of life.