Bakan Özgür Mert, Vahabi Arman, Kaya Biçer Elcil, Şahin Fahri, Kavaklı Kaan, Aydoğdu Semih
Department of Orthopedics and Traumatology, Mardin Park Private Hospital, Mardin, Türkiye.
Department of Orthopedics and Traumatology, Ege University School of Medicine, Izmir, Türkiye.
Acta Orthop Traumatol Turc. 2024 Dec 31;58(6):336-340. doi: 10.5152/j.aott.2024.24044.
This study aimed to compare preoperative and postoperative measures in haemophiliacs who had simultaneous total hip and knee arthroplasties.
A retrospective database search identified five patients with severe factor 8 deficiencies who underwent simultaneous hip and knee joint replacement surgery between 2002-2018. Preoperative and postoperative evaluations included Harris Hip Score (HHS), Knee Society Score (KSS), Knee Injury and Osteoarthritis Outcome Score (KOOS), range of motion, flexion contracture (FC), Visual Analog Scale (VAS), hip-knee angle, and leg length discrepancy.
The mean age of the patients was 50.8 years, with a mean follow-up duration of 60 months. Preoperative knee ROM was 55 degrees, improving to 73.8 degrees postoperatively. Preoperative knee FC was 13.7 degrees, improving to 10 degrees postoperatively. HHS increased from 45.6 to 75.7, KSS increased from 36 to 69.3, and KOOS total score increased from 34.4 to 82.7. VAS scores decreased from 6.3 to 1.3. One patient experienced prolonged bleeding and subsequent complications, while the others showed significant improvements.
Simultaneous hip and knee arthroplasties in hemophiliacs may provide benefits in terms of physical and functional gains. However, the increased risk of complications necessitates careful patient selection. For patients with comorbidities, staged surgeries may be advisable to avoid potential complications.
Level IV, Therapeutic study.
本研究旨在比较同时进行全髋关节和膝关节置换术的血友病患者术前和术后的各项指标。
通过回顾性数据库检索，确定了5例在2002年至2018年间接受同期髋关节和膝关节置换手术的重度Ⅷ因子缺乏患者。术前和术后评估包括Harris髋关节评分（HHS）、膝关节协会评分（KSS）、膝关节损伤和骨关节炎疗效评分（KOOS）、活动范围、屈曲挛缩（FC）、视觉模拟量表（VAS）、髋膝角和肢体长度差异。
患者的平均年龄为50.8岁，平均随访时间为60个月。术前膝关节活动范围为55度，术后改善至73.8度。术前膝关节FC为13.7度，术后改善至10度。HHS从45.6提高到75.7，KSS从36提高到69.3，KOOS总分从34.4提高到82.7。VAS评分从6.3降至1.3。1例患者出现出血时间延长及随后的并发症，而其他患者均有显著改善。
血友病患者同期进行髋关节和膝关节置换术在身体和功能改善方面可能有益。然而，并发症风险增加需要仔细选择患者。对于有合并症的患者，分期手术可能是明智的，以避免潜在并发症。
IV级，治疗性研究。
