Prosthesis survival situation and complications following total hip arthroplasty in hemophilic patients: a systematic review
Abstract Background Hemophilic arthropathy, resulting from recurrent joint bleeding in patients with hemophilia, often necessitates total hip arthroplasty (THA) to alleviate pain and improve joint function. However, the unique challenges posed by hemophilia, including coagulopathy and compromised bo...
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2025-07-01
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| Series: | BMC Musculoskeletal Disorders |
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| Online Access: | https://doi.org/10.1186/s12891-025-08919-y |
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| author | Lei Chen Shineng Lin Wenlu Zhou Yiqing Ling Zhenyu Shi Qinwen Ge Wenbin Liu Ju Li Peijian Tong Huihui Li Taotao Xu |
| author_facet | Lei Chen Shineng Lin Wenlu Zhou Yiqing Ling Zhenyu Shi Qinwen Ge Wenbin Liu Ju Li Peijian Tong Huihui Li Taotao Xu |
| author_sort | Lei Chen |
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| description | Abstract Background Hemophilic arthropathy, resulting from recurrent joint bleeding in patients with hemophilia, often necessitates total hip arthroplasty (THA) to alleviate pain and improve joint function. However, the unique challenges posed by hemophilia, including coagulopathy and compromised bone health, result in increased risks of complications such as bleeding, infection, and prosthesis loosening. Methods A systematic search of PubMed, Cochrane Library, EMBASE, and Web of Science was conducted up to September 2024. Studies reporting prosthesis survival or complications in hemophilia patients undergoing THA were included. Methodological quality was assessed using the Methodological Index for Non-Randomized Studies (MINORS) criteria. Results Fourteen retrospective cohort studies, encompassing 190 THA cases, were included. A total of 190 THA cases were involved, of which 175 prostheses survived, with aseptic loosening (57%) being the leading cause of failure. Complications included bleeding (34.8%), infections (19.7%), and aseptic loosening (15.1%). Key risk factors included reduced bone mineral density, recurrent hemarthrosis, and immune dysfunction (HIV) due to clotting factor infusions. Strategies such as preoperative optimization of clotting factors and bone quality were highlighted as crucial for improving outcomes. Conclusions This paper confirms the findings of previous studies that THA is an effective treatment for advanced-stage haemophilic arthropathy, offering significant pain relief and improved function. However, its high rate of complications has to be reduced with a correct perioperative hemostasis and a good surgical technique. This type of surgery should only be performed in centers specialized in the treatment of haemophilia by a team of surgeons expert in the implantation of hip prostheses. |
| format | Article |
| id | doaj-art-bd2016cda64b463890a0fea8dbabb605 |
| institution | Kabale University |
| issn | 1471-2474 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Musculoskeletal Disorders |
| spelling | doaj-art-bd2016cda64b463890a0fea8dbabb6052025-08-20T03:42:41ZengBMCBMC Musculoskeletal Disorders1471-24742025-07-012611910.1186/s12891-025-08919-yProsthesis survival situation and complications following total hip arthroplasty in hemophilic patients: a systematic reviewLei Chen0Shineng Lin1Wenlu Zhou2Yiqing Ling3Zhenyu Shi4Qinwen Ge5Wenbin Liu6Ju Li7Peijian Tong8Huihui Li9Taotao Xu10The First Affiliated Hospital of Zhejiang Chinese Medical University(Zhejiang Provincial Hospital of Chinese Medicine)The First Affiliated Hospital of Zhejiang Chinese Medical University(Zhejiang Provincial Hospital of Chinese Medicine)Zhejiang Chinese Medical UniversityThe First Affiliated Hospital of Zhejiang Chinese Medical University(Zhejiang Provincial Hospital of Chinese Medicine)The First Affiliated Hospital of Zhejiang Chinese Medical University(Zhejiang Provincial Hospital of Chinese Medicine)The First Affiliated Hospital of Zhejiang Chinese Medical University(Zhejiang Provincial Hospital of Chinese Medicine)The First Affiliated Hospital of Zhejiang Chinese Medical University(Zhejiang Provincial Hospital of Chinese Medicine)The First Affiliated Hospital of Zhejiang Chinese Medical University(Zhejiang Provincial Hospital of Chinese Medicine)The First Affiliated Hospital of Zhejiang Chinese Medical University(Zhejiang Provincial Hospital of Chinese Medicine)The Third Affiliated Hospital of Wenzhou Medical UniversityThe First Affiliated Hospital of Zhejiang Chinese Medical University(Zhejiang Provincial Hospital of Chinese Medicine)Abstract Background Hemophilic arthropathy, resulting from recurrent joint bleeding in patients with hemophilia, often necessitates total hip arthroplasty (THA) to alleviate pain and improve joint function. However, the unique challenges posed by hemophilia, including coagulopathy and compromised bone health, result in increased risks of complications such as bleeding, infection, and prosthesis loosening. Methods A systematic search of PubMed, Cochrane Library, EMBASE, and Web of Science was conducted up to September 2024. Studies reporting prosthesis survival or complications in hemophilia patients undergoing THA were included. Methodological quality was assessed using the Methodological Index for Non-Randomized Studies (MINORS) criteria. Results Fourteen retrospective cohort studies, encompassing 190 THA cases, were included. A total of 190 THA cases were involved, of which 175 prostheses survived, with aseptic loosening (57%) being the leading cause of failure. Complications included bleeding (34.8%), infections (19.7%), and aseptic loosening (15.1%). Key risk factors included reduced bone mineral density, recurrent hemarthrosis, and immune dysfunction (HIV) due to clotting factor infusions. Strategies such as preoperative optimization of clotting factors and bone quality were highlighted as crucial for improving outcomes. Conclusions This paper confirms the findings of previous studies that THA is an effective treatment for advanced-stage haemophilic arthropathy, offering significant pain relief and improved function. However, its high rate of complications has to be reduced with a correct perioperative hemostasis and a good surgical technique. This type of surgery should only be performed in centers specialized in the treatment of haemophilia by a team of surgeons expert in the implantation of hip prostheses.https://doi.org/10.1186/s12891-025-08919-yHemophilia AHemophilia BArthroplastyReplacementHipComplications |
| spellingShingle | Lei Chen Shineng Lin Wenlu Zhou Yiqing Ling Zhenyu Shi Qinwen Ge Wenbin Liu Ju Li Peijian Tong Huihui Li Taotao Xu Prosthesis survival situation and complications following total hip arthroplasty in hemophilic patients: a systematic review BMC Musculoskeletal Disorders Hemophilia A Hemophilia B Arthroplasty Replacement Hip Complications |
| title | Prosthesis survival situation and complications following total hip arthroplasty in hemophilic patients: a systematic review |
| title_full | Prosthesis survival situation and complications following total hip arthroplasty in hemophilic patients: a systematic review |
| title_fullStr | Prosthesis survival situation and complications following total hip arthroplasty in hemophilic patients: a systematic review |
| title_full_unstemmed | Prosthesis survival situation and complications following total hip arthroplasty in hemophilic patients: a systematic review |
| title_short | Prosthesis survival situation and complications following total hip arthroplasty in hemophilic patients: a systematic review |
| title_sort | prosthesis survival situation and complications following total hip arthroplasty in hemophilic patients a systematic review |
| topic | Hemophilia A Hemophilia B Arthroplasty Replacement Hip Complications |
| url | https://doi.org/10.1186/s12891-025-08919-y |
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