title: Total hip arthroplasty via the direct anterior approach with Kerboull-type acetabular reinforcement device for an elderly female with factor XI deficiency.
abstract: We present a case of successful and uncomplicated total hip arthroplasty with an acetabular reinforcement device in an elderly patient with hip osteoarthritis already diagnosed with factor XI deficiency, which is a very rare bleeding disorder and at high risk of post-operative haemorrhage, and it poses a substantial challenge to surgeons as a consequence of the specific risks of infection and fixation failure. Moreover, bone fragility in elderly patient increases potential risk of adverse event. Fresh frozen plasma was used to supplement factor XI activity. Importantly, transfusion-transmitted disease such as having factor XI inhibitor was promptly surveyed prior to the supplement since the patient had previous history of the administration of fresh frozen plasma. Under prompt and effective peri-operative haemostasis, rigid implant fixation and rigorous attention to the prevention of infection seem to achieve the best possible outcomes for elderly patients with a bleeding disorder undergoing total hip arthroplasty.
authors.affiliation: Department of Orthopaedic Surgery, Juntendo University, Tokyo 113-0033, Japan.
authors.forename: Kei
authors.initials: K
authors.lastname: Sano
authors.affiliation: Department of Orthopaedic Surgery, Juntendo University, Tokyo 113-0033, Japan.
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Homma
authors.affiliation: Department of Orthopaedic Surgery, Juntendo University, Tokyo 113-0033, Japan.
authors.forename: Tomonori
authors.initials: T
authors.lastname: Baba
authors.affiliation: Division of Hematology, Department of Internal Medicine, Juntendo University, Tokyo 113-0033, Japan.
authors.forename: Jun
authors.initials: J
authors.lastname: Ando
authors.affiliation: Department of Orthopaedic Surgery, Juntendo University, Tokyo 113-0033, Japan.
authors.forename: Mikio
authors.initials: M
authors.lastname: Matsumoto
authors.affiliation: Department of Orthopaedic Surgery, Juntendo University, Tokyo 113-0033, Japan.
authors.forename: Hideo
authors.initials: H
authors.lastname: Kobayashi
authors.affiliation: Department of Orthopaedic Surgery, Juntendo University, Tokyo 113-0033, Japan.
authors.forename: Takahito
authors.initials: T
authors.lastname: Yuasa
authors.affiliation: Department of Orthopaedic Surgery, Juntendo University, Tokyo 113-0033, Japan.
authors.forename: Kazuo
authors.initials: K
authors.lastname: Kaneko