Multidiciplinary treatment of a haemophilic person with total hip replacement surgery - A case report

Abstract

Background: Treatment of hemophilic arthropathy may be conservative and operative. Conservative therapy includes medications and physiotherapy, and surgery includes synovectomy, tendon release, capsulotomy, osteotomy and total joint arthroplasty. During physiotherapy, surgery and postoperative rehabilitation haemophiliacs need to receive clotting factor. Aim: We present our first experience in multidisciplinary treatment of a patient with severe haemophilia A during and after total hip replacement surgery, the patient's outcome after postoperative rehabilitation treatment and 6 months later. Material and Methods: In a patient, age 28, with severe Haemophilia A, hip replacement surgery with total hip cementless prosthesis on his left hip was undertaken. Prophylaxis was done with concentrate of human coagulation factor VIII. Patient assessment was made with clinical findings, VAS for pain, Harris Hip Score for surgery outcome. Results: The postoperative rehabilitation treatment program consisted of exercise therapy, occupational therapy and education. After the rehabilitation Harris Hip Score was 79 points, and 89 after six months follow-up. Conclusion: The arthroplasty of the hip can be a valuable option in the management of severe hemophilic arthropathy. The successful outcome of replacement surgery in haemophilia depends upon a close collaboration between the orthopaedic surgeon, heamatologist/specialist of transfusion medicine, physiatrist and other team members. © 2013 Nikolikj-Dimitrova E.