Volume 14 Issue 4
Jul.  2023
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CHEN Bo, XU Yimin, PENG Huiming, FENG Bin, LIU Guanmo, WANG Xueqing, WENG Xisheng. Comparison of the Risk of Perioperative Blood Loss in Hemophilic Arthritis and Initial Total Hip Arthroplasty for Femoral Head Necrosis under Multimodal Blood Management Measures: A Retrospective Cohort Study[J]. Medical Journal of Peking Union Medical College Hospital, 2023, 14(4): 814-819. doi: 10.12290/xhyxzz.2023-0009
Citation: CHEN Bo, XU Yimin, PENG Huiming, FENG Bin, LIU Guanmo, WANG Xueqing, WENG Xisheng. Comparison of the Risk of Perioperative Blood Loss in Hemophilic Arthritis and Initial Total Hip Arthroplasty for Femoral Head Necrosis under Multimodal Blood Management Measures: A Retrospective Cohort Study[J]. Medical Journal of Peking Union Medical College Hospital, 2023, 14(4): 814-819. doi: 10.12290/xhyxzz.2023-0009

Comparison of the Risk of Perioperative Blood Loss in Hemophilic Arthritis and Initial Total Hip Arthroplasty for Femoral Head Necrosis under Multimodal Blood Management Measures: A Retrospective Cohort Study

doi: 10.12290/xhyxzz.2023-0009
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  •   Objective  To compare the perioperative blood loss and risk of allogeneic transfusion between hemophilia arthritis (HA) patients and osteonecrosis of the femoral head (ONFH) patients undergoing unilateral total hip arthroplasty (THA) under multimodal blood management measures.  Methods  Clinical data of HA patients treated with unilateral THA from January 2010 to June 2022 and ONFH patients matched 1:3 by gender were retrospectively collected at Peking Union Medical College Hospital, and the differences in indicators related to perioperative blood loss and complication rates were compared between the two groups.  Results  A total of 26 patients with HA and 76 patients with ONFH who met the inclusion and exclusion criteria were enrolled.Compared with ONFH patients, the total blood loss[(1927.08±956.59) mL vs.(1475.88±924.43) mL, P=0.036], major bleeding rate (38.46%vs. 14.47%, P=0.009), allogeneic transfusion rate (15.38%vs. 3.95%, P=0.046), and complication rate (34.62%vs. 7.89%, P=0.000) in HA patients were higher, and postoperative day 3 hemoglobin[(112.94±12.26) g/L vs.(117.40±11.17) g/L, P=0.000]and hematocrit[(29.44±7.96)%vs.(32.80±5.52)%, P=0.019]were lower.  Conclusion  The risk of perioperative blood loss and allogeneic transfusion is higher in HA patients treated with unilateral THA than in ONFH-THA patients, and further optimization of blood management strategies is needed.
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  • [1] Ferguson RJ, Palmer AJ, Taylor A, et al. Hip replacement[J]. Lancet Lond Engl, 2018, 392: 1662-1671. doi:  10.1016/S0140-6736(18)31777-X
    [2] Sehat KR, Evans RL, Newman JH. Hidden blood loss following hip and knee arthroplasty. Correct management of blood loss should take hidden loss into account[J]. J Bone Joint Surg Br, 2004, 86: 561-565. doi:  10.2106/00004623-200403000-00015
    [3] Park JH, Rasouli MR, Mortazavi SMJ, et al. Predictors of perioperative blood loss in total joint arthroplasty[J]. J Bone Joint Surg Am, 2013, 95: 1777-1783. doi:  10.2106/JBJS.L.01335
    [4] Carling MS, Jeppsson A, Eriksson BI, et al. Transfusions and blood loss in total hip and knee arthroplasty: a prospective observational study[J]. J Orthop Surg, 2015, 10: 48. doi:  10.1186/s13018-015-0188-6
    [5] Parsa A, Azizbaig Mohajer M, Mirzaie M, et al. Hip arthroplasty in haemophilia: a systematic review[J]. HIP Int, 2018, 28: 459-467. doi:  10.1177/1120700018793777
    [6] Berntorp E, Fischer K, Hart DP, et al. Haemophilia[J]. Nat Rev Dis Primer, 2021, 7: 45. doi:  10.1038/s41572-021-00278-x
    [7] Strauss AC, Rommelspacher Y, Nouri B, et al. Long-term outcome of total hip arthroplasty in patients with haemophilia[J]. Haemophilia, 2017, 23: 129-134. doi:  10.1111/hae.13045
    [8] Wu G, Zhai J, Feng B, et al. Total Hip Arthroplasty in Hemophilia Patients: A Mid-term to Long-term Follow-up[J]. Orthop Surg, 2017, 9: 359-364. doi:  10.1111/os.12354
    [9] 翟吉良, 翁习生, 彭慧明, 等. 血友病性关节炎及骨关节炎患者膝关节置换术后出血量的比较[J]. 中国医学科学院学报, 2012, 34: 613-616. https://www.cnki.com.cn/Article/CJFDTOTAL-ZYKX201206016.htm
    [10] Nelson IW, Sivamurugan S, Latham PD, et al. Total hip arthroplasty for hemophilic arthropathy[J]. Clin Orthop, 1992(276): 210-213.
    [11] Huang ZY, Huang Q, Zeng HJ, et al. Tranexamic acid may benefit patients undergoing total hip/knee arthroplasty because of haemophilia[J]. BMC Musculoskelet Disord, 2019, 20: 402. doi:  10.1186/s12891-019-2767-x
    [12] Peng H, Wang L, Zhai J, et al. Incidence of Symptomatic Venous Thromboembolism in Patients with Hemophilia Undergoing Hip and Knee Joint Replacement without Chemoprophylaxis: A Retrospective Study[J]. Orthop Surg, 2019, 11: 236-240. doi:  10.1111/os.12444
    [13] Swystun LL, James PD. Genetic diagnosis in hemophilia and von Willebrand disease[J]. Blood Rev, 2017, 31: 47-56. doi:  10.1016/j.blre.2016.08.003
    [14] 卫生部办公厅. 关于印发《临床输血技术规范》的通知[EB/OL]. (2001-11-08)[ 2023-01-05]. http://www.nhc.gov.cn/wjw/gfxwj/200111/2c93606209ec4a25ad9241787f9f7404.shtml.
    [15] 中华医学会骨科学分会关节外科学组, 中国血友病协作组, 童培建, 等. 中国血友病性骨关节病髋膝关节置换围手术期管理指南[J]. 中华骨与关节外科杂志, 2022, 15: 481-490. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGJW202207001.htm
    [16] Liu X, Zhang X, Chen Y, et al. Hidden blood loss after total hip arthroplasty[J]. J Arthroplasty, 2011, 26: 1100-1105. doi:  10.1016/j.arth.2010.11.013
    [17] Colgan G, Baker JF, Donlon N, et al. Total hip arthroplasty in patients with haemophilia-What are the risks of bleeding in the immediate peri-operative period?[J]. J Orthop, 2016, 13: 389-393. doi:  10.1016/j.jor.2016.06.022
    [18] Bellingham A, Fletcher D, Kirwan EO, et al. Hip arthroplasty in a haemophiliac and subsequent prophylactic therapy with cryoprecipitate[J]. Br Med J, 1967, 4: 531-532. doi:  10.1136/bmj.4.5578.531
    [19] Shen SN, Wu DX, Lv SJ, et al. Hidden blood loss of total knee arthroplasty in hemophilia arthritis: an analysis of influencing factors[J]. BMC Musculoskelet Disord, 2022, 23: 587. doi:  10.1186/s12891-022-05535-y
    [20] Kleiboer B, Layer MA, Cafuir LA, et al. Postoperative bleeding complications in patients with hemophilia undergo-ing major orthopedic surgery: A prospective multicenter observational study[J]. J Thromb Haemost, 2022, 20: 857-865. doi:  10.1111/jth.15654
    [21] Zhai J, Weng X, Lin J, et al. Efficacy of a modified coagulation factor substitution for total hip arthroplasty in patients with end-stage haemophilic arthropathy[J]. Blood Coagul Fibrinolysis, 2017, 28: 24-27. doi:  10.1097/MBC.0000000000000527
    [22] Kapadia BH, Boylan MR, Elmallah RK, et al. Does Hemophilia Increase the Risk of Postoperative Blood Transfusion After Lower Extremity Total Joint Arthroplasty?[J]. J Arthroplasty, 2016, 31: 1578-1582. doi:  10.1016/j.arth.2016.01.012
    [23] Wang SH, Chung CH, Chen YC, et al. Does Hemophilia Increase Risk of Adverse Outcomes Following Total Hip and Knee Arthroplasty? A Propensity Score-Matched Analysis of a Nationwide, Population-Based Study[J]. J Arthroplasty, 2019, 34: 2329-2336. doi:  10.1016/j.arth.2019.05.062
    [24] Gillinov SM, Burroughs PJ, Moore HG, et al. Total Hip Arthroplasty in Patients With Classic Hemophilia: A Matched Comparison of 90-Day Outcomes and 5-Year Implant Survival[J]. J Arthroplasty, 2022, 37: 1333-1337. doi:  10.1016/j.arth.2022.02.107
    [25] Almeida RP, Mokete L, Sikhauli N, et al. The draining surgical wound post total hip and knee arthroplasty: what are my options? A narrative review[J]. EFORT Open Rev, 2021, 6: 872-880. doi:  10.1302/2058-5241.6.200054
    [26] Kaseb MH, Shafiee SH, Shamabadi A, et al. Cementless total hip arthroplasty in haemophilia patients through direct anterior approach[J]. Haemophilia, 2021, 27: e239-e244. 6.
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