Total hip arthroplasty (THA) is an effective treatment for end-stage haemophilic
arthropathy, and substitution
therapy plays a key role in the success of THA. The aim of this study was to evaluate the efficacy of a modified
coagulation factor substitution regime in THA. Nineteen haemophiliac patients (20 hips) who received primary cementless THA were enrolled. Based on World Federation of
Haemophilia (WFH) guideline, a modified
coagulation factor substitution regime was adopted. Blood loss, implant survival rates and complications were reviewed, retrospectively. The mean age at surgery was 29.7 years (15-49 years) and the mean follow-up period was 91 months (43-151 months). Mean total blood loss, external blood loss and hidden blood loss were 3543 (1494-7576), 1435 (600-3440), and 2110 ml (534-4402), respectively. Mean intraoperative blood loss and postoperative drainage were 715 (300-2000) and 713 ml (200-2950), respectively. Mean
red blood cell transfusion used was 5 U (0-14). All
prostheses were found to have bony ingrowth. One patient had
hematoma formation in the thigh and one with a lower limb
deep vein thrombosis, postoperatively. Other complications included one
skin ulcer, one femur splitting fracture, and one transient neuropraxia. Intraoperative blood loss and
wound drainage, in our study, were similar to that in haemophiliac patients and nonhaemophilic patients in literature. This supports the efficacy of the modified
coagulation factor substitution strategy in our study.