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KMID : 0386720030150030177
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Journal of the Korean Hip Society
2003 Volume.15 No. 3 p.177 ~ p.184
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Cementless Total Hip Arthroplasty in Hemophilic Arthritis
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Yoo Myung-Chul
Cho Yoon-Je
Kim Kang Il
Chun Young-Soo
Bae Sung-Chul
Moon Jee-Soo
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Abstract
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Purpose: The aim of this study was to analyze the clinical and radiological data from hemophilic arthritis patients following cementless total hip arthroplasty (THA).
Subject and Method: Of 18 patients, 15 were available for follow-up observation for over two years, so were chosen as the analysis. The average age of the patients was 34 years. A non-cemented type acetabular cup and femoral stem was used in all of the cases. The average follow-up period was 5.5 years. The Harris hip score, range of hip joint motion and pain were all clinically evaluated. The problems associated with the perioperative use of coagulation factors and complication associated with bleeding after surgeries were investigated. The fixation of the acetabular cup and femoral stem, loosening and the presence of osteolysis were also evaluated.
Results: The Harris hip score improved from 56.4 before surgery to 93.3 at the time of the last follow-up. In terms of the range of motion, the flexion contracture improved from 7.3 before to 4.2 degrees after surgery. The further flexion improved from 65.2 before to 85.0 degrees after surgery. All the patients showed a significant reduction in pain. The patients received an average of 3700 units of antihemophilic coagulation factors VIII per month before surgery, but at the time of the last follow-up, this had significantly reduced to 1450 units per month. During and after surgery, an average of 3.5 pints of blood were transfused, with an average of 52,000 units of coagulation factors required. At the time of the last follow-up, all cases showed a stable fixation of the cup and stem, with no evidence of implant loosening or osteolysis.
Conclusion: In moderate or severe cases of hip joint hemophilic arthritis, a THA is greatly effective in reducing the pain. The reduced incidences of bleeding in the hip joint after a THA reduces the amount of coagulation factor required.
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KEYWORD
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Hemophilic arthritis, Cementless total hip arthroplasty
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