Analysis of the Early Clinical Effect of Simultaneous Ipsilateral Total Hip and Knee Arthroplasty in the Treatment of End-stage Hemophilic Arthritis

Abstract

ObjectiveTo evaluate the clinical efficacy of simultaneous ipsilateral total hip arthroplasty (THA) and total knee arthroplasty (TKA) in the treatment of advanced hemophilic arthritis. Methodthe clinical data of 8 patients with advanced hemophilic arthritis, with ages of 31.6±6.2 years (ranging from 25-38 years, who underwent ipsilateral THA and TKA at the ** Hospital from January 2018 to May 2021 were retrospectively analyzed. There were 6 cases of hemophilia A and 2 cases of hemophilia B. The preoperative level of coagulation factor VIII was 1.8(±1.3)%，activated partial prothrombin time (aPTT) was 131.2 (±35.3) s. A comparison of the Harris score before and 0.3-1 year after operation was performed to evaluate hip function, American hospital for special surgery (HSS) knee score and American Knee society score (KSS) score. ResultDuring the follow-up period of 1.4 (± 1.1) years, no intra-articular bleeding and skin dehiscence were found in the early postoperative period, and no joint infection, bleeding, prosthesis loosening and sinking were found in the last follow-up visit. The Harris score increased from 16.8 (± 4.4) preoperatively to 77.6 (± 7.1) postoperatively, HSS knee score increased from 41.8 (± 4.2) preoperatively to 76.0 (± 5.8) postoperatively, the clinical KSS increased from 35.6 (± 10.8) preoperatively to 79.2 (± 6.9) postoperatively. The KSS increased from 22.8 (± 8.4) preoperatively to 72.0 (± 5.9) postoperatively at the last follow-up visit. The differences were statistically significant (P < 0.05).ConclusionsIpsilateral THA and TKA in the treatment of advanced hemophilic arthritis can effectively relieve pain, and improve hip and knee joint function, as well as the quality of life, and can thus be recommended as a safe and effective measure for the treatment of advanced hemophilic arthritis.