Cementless total hip arthroplasty in patient with severe haemophilia A: a case report and literature review

Background: Given the fact that haemophilic arthropathy of the hip is much less common than that of the knee, elbow or ankle, only limited papers with small study populations have been published to report on the surgical management and outcomes of total hip arthroplasty in haemophilic hip arthropathy. Moreover, more than half of the studies were regarding cemented implants with a relatively high rate of failure. Case presentation: We report a 26-year-old male with severe hemophilia A who demonstrated hemophiliac arthropathy in his bilateral hip joint, especially the right hip. Because of financial difficulty, total cementless hip arthroplasty for the right hip was performed under a modified factor VIII replacement therapy by a multidisciplinary team consisted of orthopaedic surgeons, haematologists, physiatrists and physical therapist. The patient underwent a physiotherapeutic postoperative rehabilitation program from the first day after surgery to the 3rd weekend after the patient out of the hospital. The whole process was safely managed without any excess bleeding or adverse effects. One year after the surgery, satisfactory functional outcomes were obtained. Conclusion: The authors experienced a cementless total hip arthroplasty in a young patient with severe haemophilic hip arthropathy and achieved satisfactory result without complications in a short follow-up period. It is supported that a successful arthroplasty and adequate replacement of clotting factor combined with a meticulous team approach are the key factors to ensure the good outcomes.