Hip Pelvis.  2016 Mar;28(1):24-28. 10.5371/hp.2016.28.1.24.

Total Hip Arthroplasty in Patient with Aplastic Anemia

• Lim YW
• Kim SC
• Kwon SY
• Park DJ
• Kim YS

• KMID: 2161311
• DOI: http://doi.org/10.5371/hp.2016.28.1.24

Abstract

PURPOSE
Patients with aplastic anemia (AA) are now living longer and therefore are at increased risk for the development of osteonecrosis of the hip. However, studies on the results of total hip arthroplasty (THA) are lacking. The purpose of this study is to present the result of THA in patients with AA.
MATERIALS AND METHODS
We retrospectively reviewed the data for a group of 29 patients (45 hips) with AA who presented to our institution for THA between May 2008 and May 2012. All hips were replaced because of osteonecrosis of the femoral head. A specific prospective protocol was followed for the perioperative transfusion of platelets and blood. The clinical and radiographic evaluations were done, and the minimum follow-up period was 3 years (mean, 49.2 months; range, 36 to 84 months).
RESULTS
Three hips had excessive perioperative bleeding and hematoma formation, and then hematoma evacuations were done; one hip was finally revised because of infection of acetabular component. One patient with poorly controlled AA died due to delayed infection on the hip joint. All hips showed stable fixation, and the mean Harris hip score was improved from 54.2 points (range, 42 to 69 points) preoperatively to 90.8 points (range, 73 to 97 points) at the time of the latest follow-up.
CONCLUSION
In the present study, the durability of implant fixation was maintained and the clinical results demonstrated a sustained increase in function of the hip. Postoperatively, paying attention to bleeding and infection should be needed.

Keyword

Aplastic anemia; Osteonecrosis; Hip replacement arthroplasty

MeSH Terms

Acetabulum
Anemia, Aplastic*
Arthroplasty, Replacement, Hip*
Follow-Up Studies
Head
Hematoma
Hemorrhage
Hip
Hip Joint
Humans
Osteonecrosis
Prospective Studies
Retrospective Studies

Figure

• 

  Fig. 1 Radiographic images. (A) Anteroposterior radiograph of the pelvis of a 43-year-old female with severe aplastic anemia, showing osteonecrosis of the femoral head and consequent joint destruction. (B) An immediate postoperative radiograph showing total hip arthroplasty with good positioning of the prosthesis. (C) The patient visited the emergency room due to acute onset severe right hip pain, and a follow-up radiograph showed an extensive gas formation around acetabular and femoral components (arrow). (D) A postoperative radiograph after debridement and irrigation. Removal of prosthesis was not performed due to the deteriorated hematologic status of the patient.

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