title: Total Hip Arthroplasty for Rapidly Destructive Coxarthrosis in a Patient with Severe Platelet Deficiency due to Liver Cirrhosis and Immune Thrombocytopenic Purpura.
abstract: Rapidly destructive coxarthrosis (RDC) causes rapid and extreme destruction of the hip joint, which was reported by Postel and Kerboull. RDC is commonly unilateral and occurs mostly in elderly women. Immune thrombocytopenic purpura (ITP) is characterized by a low platelet count that is the result of both immune-mediated platelet destruction and suppression of platelet production. In patients with ITP undergoing surgery, bleeding associated with a low preoperative platelet count can lead to unsuccessful outcomes. To the best of our knowledge, there has been only one report describing total hip arthroplasty (THA) for patients with ITP and there have been no reports of THA for RDC with a very low platelet count due to liver cirrhosis (LC) and ITP. We report the case of a patient who had right RDC and a very low platelet count due to LC and ITP in whom THA was successfully performed. Furthermore, this case was also unique in that her platelet count increased after THA. THA for right RDC might resolve ITP by relieving inflammation of the right hip since her platelet count recovered after THA.
authors.affiliation: Department of Orthopaedic Surgery, Osaka General Hospital, West Railway Company, 1-2-22 Abeno-ku Matsuzaki-cho, Osaka, Osaka Prefecture 545-0053, Japan.
authors.forename: Shunpei
authors.initials: S
authors.lastname: Hama
authors.affiliation: Department of Orthopaedic Surgery, Osaka General Hospital, West Railway Company, 1-2-22 Abeno-ku Matsuzaki-cho, Osaka, Osaka Prefecture 545-0053, Japan.
authors.forename: Fumiaki
authors.initials: F
authors.lastname: Inori
authors.affiliation: Department of Hematology, Osaka General Hospital, West Railway Company, 1-2-22 Abeno-ku Matsuzaki-cho, Osaka, Osaka Prefecture 545-0053, Japan.
authors.forename: Dai
authors.initials: D
authors.lastname: Momose
authors.affiliation: Department of Orthopaedic Surgery, Osaka General Hospital, West Railway Company, 1-2-22 Abeno-ku Matsuzaki-cho, Osaka, Osaka Prefecture 545-0053, Japan.
authors.forename: Sadahiko
authors.initials: S
authors.lastname: Konishi