Hip arthroplasty in haemophilia: a systematic review

Abstract

Background: Rigorous haemostatic control and careful rehabilitation are essential for haemophilic patients undergoing total hip arthroplasty (THA). Aim: to examine the current literature regarding THA in patients with haemophilia in order to determine clinical outcomes and complication rates. Methods: We included 11 case reports/series and 9 original articles. There was a total of 206 patients who underwent 226 THAs. Findings: The number of patients enrolled in the selected articles varied from 1 in case reports to 34 in the original articles. Gender was documented in 10. Mean age at surgery was 41 years. Mean follow-up was 73 months (standard deviation [SD] 35 months). All but 4 articles specified whether implants were cemented or uncemented, with 95% being uncemented, 3.5% being cemented, and 1.5% being hybrid (uncemented acetabular component, cemented femoral stem). Conclusion: Controlled hypotensive anaesthesia (to reduce preoperative blood loss), consult with haematologist, precise control of haemostasis status per the guidelines defined by the World Federation joint replacement, can improve the success rate and hip replacement surgery can be performed safely.