Joint replacement for a spontaneously ankylosed hip in a haemophilic patient

Abstract

A cemented Charnley total hip prosthesis was implanted in a 48-year-old man with mild haemophilia (factor VIII 4 IU dL-1) in his right spontaneously ankylosed hip. At the time of surgery he was anti-HCV positive, anti-HIV negative, and no circulating inhibitors were encountered. The indication for surgery was long-lasting intractable low back and ipsilateral knee pain. At 4-month follow-up, relief of pain was achieved as well as correction of limb-length discrepancy, with a good result according to the Mayo Clinic hip score. Doses of 50 IU kg-1 body weight of recombinant factor VIII (Recombinate; Baxter, Glendale, California, USA) was used during the 2 weeks of admittance to the hospital. The dosage was adjusted according to the recoveries of factor VIII, with an overall factor consumption of 68 000 IU. As far as we know this is the first case reported in the literature of a person with haemophilia in whom a spontaneous hip ankylosis has been satisfactorily converted in a total hip arthroplasty with a short-term follow-up. However, a much longer follow-up is still needed to ascertain the efficacy of this surgical procedure in haemophilia.

Total joint arthroplasty in haemophilia

“…The main indication is severe and intractable pain at the low back and at the ipsilateral knee. One conversion of a spontaneously ankylosed hip has been converted to a THA in an HIV-negative patient, with a satisfactory result [39].…”

Hip arthroplasty in haemophilia: a systematic review

“…Another suitable study was found, giving us a final yield of 20 articles. 8,[10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28] Figure 1 outlines the literature search process.…”

Total joint arthroplasty: the final solution for knee and hip when synovitis could not be controlled

“…The main indication is severe and intractable pain at the low back and at the ipsilateral knee. One spontaneously ankylosed hip has been converted to a THA in a HIV-negative patient, with a satisfactory result [40].…”

“…The results of 35 primary TKAs performed in 30 haemophilic patients between 1996 and 2005 (10year period) were reviewed retrospectively. The average age of patients was 31 years (range: [24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41][42] and the average follow-up was 7.5 years (range: 1-10). Twenty-five patients had haemophilia A and five had haemophilia B.…”