title: Long-term outcome of total hip arthroplasty in patients with haemophilia.
abstract: BACKGROUND
  Besides the target joints (elbow, knee and ankle), the hip is one of the commonly affected joints in haemophilic arthropathy. Hip arthroplasty is the therapy of choice after failure of conservative treatment. There are only limited data on long-term results after primary total hip arthroplasty (THA).
  
  
  OBJECTIVE
  The aim of this retrospective study was to analyse clinical outcome and complication rate after total hip replacement in patients with severe haemophilic arthropathy.
  
  
  METHODS
  Forty-three patients with haemophilia (PWH), one patient with von Willebrand disease and one patient with a Factor-VII-deficiency undergoing 49 total hip arthroplasties, were evaluated in a retrospective study. Harris hip score (HHS), range of motion (ROM), pain status (visual analogue scale, VAS) complication rate and patient satisfaction were assessed at a mean follow-up of 11.5 years (range: 3-32).
  
  
  RESULTS
  HSS, ROM and VAS improved significantly combined with high patient satisfaction. In total, three (6.1%) periprosthetic infections and five (10.2%) aseptic implant loosenings occurred after THA leading to revision arthroplasty. In two (4.1%) cases, a pseudotumour and one (2.0%) periarticular ossification had to be resected after THA.
  
  
  CONCLUSIONS
  Total hip replacement in PWH leads to a significant increase of function, reduction of pain and a high satisfaction. Due to the relatively high complication rate (infections and aseptic loosening) compared to patients without haemophilia, an individual assessment of the risk-benefit ratio from surgical and haemostaseological point of view is needed.
authors.affiliation: Department of Orthopaedics and Trauma Surgery, University of Bonn, Bonn, Germany.
authors.forename: A C
authors.initials: AC
authors.lastname: Strauss
authors.affiliation: Department of Orthopaedics and Trauma Surgery, University of Bonn, Bonn, Germany.
authors.forename: Y
authors.initials: Y
authors.lastname: Rommelspacher
authors.affiliation: Department of Orthopaedics and Trauma Surgery, University of Bonn, Bonn, Germany.
authors.forename: B
authors.initials: B
authors.lastname: Nouri
authors.affiliation: Department of Orthopaedics and Trauma Surgery, University of Bonn, Bonn, Germany.
authors.forename: R
authors.initials: R
authors.lastname: Bornemann
authors.affiliation: Department of Orthopaedics and Trauma Surgery, University of Bonn, Bonn, Germany.
authors.forename: M D
authors.initials: MD
authors.lastname: Wimmer
authors.affiliation: Institute for Experimental Haematology and Transfusion Medicine, University of Bonn, Bonn, Germany.
authors.forename: J
authors.initials: J
authors.lastname: Oldenburg
authors.affiliation: Department of Orthopaedics and Trauma Surgery, University of Bonn, Bonn, Germany.
authors.forename: P H
authors.initials: PH
authors.lastname: Pennekamp
authors.affiliation: Department of Orthopaedics and Trauma Surgery, University of Bonn, Bonn, Germany.
authors.forename: J
authors.initials: J
authors.lastname: Schmolders
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001178:Arthroplasty / Q000379:methods*; D019644:Arthroplasty, Replacement, Hip / Q000379:methods*; D005260:Female; D006467:Hemophilia A / Q000150:complications*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome
keywords: arthropathy; arthroplasty; haemophilia; total hip replacement