Open AccessTotal Hip Arthroplasty in Hemophilia Patients: A Mid‐term to Long‐term Follow‐up
Author(s) -
Wu Guoliang,
Zhai Jiliang,
Feng Bin,
Bian Yanyan,
Xu Chi,
Weng Xisheng
Publication year - 2017
Publication title -
orthopaedic surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.666
H-Index - 23
eISSN - 1757-7861
pISSN - 1757-7853
DOI - 10.1111/os.12354
Subject(s) - medicine , surgery , perioperative , harris hip score , blood transfusion , clotting factor , implant , total hip arthroplasty , arthroplasty , blood loss , survivorship curve , orthopedic surgery , population , environmental health
Objective To report the results of mid‐term to long‐term follow‐up after primary total hip arthroplasty (THA) in hemophiliacs and to hypothesize that THA can provide satisfactory outcomes in these patients. Methods Twenty‐four primary THA performed in 21 hemophilia patients between 2002 and 2012 were reviewed retrospectively, including 20 cases of hemophilia A and 1 case of hemophilia B. The standard lateral approach was used for all implantations. Substitution therapy for factor VIII and activated prothrombin complex concentrates were administered to patients with hemophilia A and B, respectively. Total and hidden blood loss were calculated. Outcomes were assessed using the Harris hip score before surgery and at the final follow‐up visit. Complications were recorded by clinical and radiographic assessment and then compared to those in previous reports. Results The mean follow‐up period was 113 months (range, 5–15 years). The average total blood loss was 3559 mL (range, 1494–7506 mL). The mean amount of red blood cell (RBC) transfusion was 4.4 U (range, 0–14 U). The mean amount of clotting factor used in the perioperative period for management of hemophilia was 14 031.3 U (range, 8100–25 200 U). Harris hip scores improved from 37 points (range, 15–81) before surgery to 90 points (range, 70–96) at the last follow‐up. No signs of loosening, infection or other complications of the implant components occurred after discharge. The overall survivorship of the implants was 100% for all patients, and no revision surgery was performed. Conclusions With modern techniques and hematological management, THA in patients with hemophilia leads to significant improvement in joint function with a relatively low incidence of complications. Increased blood loss and substitution therapy have no obvious negative influences on the mid‐term to long‐term results of THA.