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

Abstract

Object: To investigate the clinical efficacy of simultaneous ipsilateral Total Hip Arthroplasty (THA) and Total Knee Arthroplasty (TKA) in the treatment of advanced hemophilic arthritis. Method: The clinical data of 8 patients with advanced hemophilic arthritis who underwent ipsilateral THA and TKA in the Second Affiliated Hospital of Chongqing Medical University from January 2018 to may 2021 were retrospectively analyzed, ages are (31.6 ± 6.2) years old (25-38 year). 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%, Partial Prothrombin Time (APTT) was (131.2 ± 35.3). Coagulation factor VIII arthroplasty therapy was used for type a hemophilia during perioperative period, and coagulation factor X arthroplasty therapy was used for type B hemophilia during perioperative period. All patients had informed consent to the treatment plan and were approved by the hospital ethics committee. Harris score before and 0.3-1 year after operation was compared to evaluate hip function, HSS knee score and KSS score. Result: During the follow-up 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. 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, KSS clinical score increased from (35.6 ± 10.8) preoperatively to (79.2 ± 6.9) postoperatively, The KSS score increased from (22.8 ± 8.4) preoperatively to (72.0 ± 5.9) postoperatively at the last follow-up. The differences were statistically significant (P<0.05). Conclusion: The same side THA and TKA in the treatment of advanced hemophilic arthritis can effectively relieve pain, improve hip and knee joint function, and improve the quality of life, which is a safe and effective measure for the treatment of advanced hemophilic arthritis.