Bleeder's Femur: The Proximal Femoral Morphology in Hemophilic Patients Who Underwent Total Hip Arthroplasty.
Differences
Hemophilia
Hemophilic Arthritis
Morphology
Proximal Femur
Total Hip Arthroplasty
Journal
Orthopaedic surgery
ISSN: 1757-7861
Titre abrégé: Orthop Surg
Pays: Australia
ID NLM: 101501666
Informations de publication
Date de publication:
05 Jan 2024
05 Jan 2024
Historique:
revised:
23
11
2023
received:
01
09
2023
accepted:
04
12
2023
medline:
5
1
2024
pubmed:
5
1
2024
entrez:
5
1
2024
Statut:
aheadofprint
Résumé
Patients with hemophilia (PWH) constantly suffer hemarthrosis, which leads to deformity of the hip joint. Therefore, PWH who are going to receive total hip arthroplasty (THA) should be exclusively treated before the surgery with careful measurement of their proximal femur. Hence, we conducted a retrospective study to explore the anatomical parameters of and differences in the proximal femur in hemophilic patients who underwent THA. The retrospective study comprised data of adult patients who received total hip arthroplasty from 2020 to 2022 in the research center. Patients having a diagnosis of hemophilic arthritis and received THA were included in experimental group, and patients with hip arthritis or femoral head necrosis were taken as control group. Parameters including femoral offset, neck-shaft angle (NSA), medullary cavity of 20 mm above mid-lesser trochanter level (T+20), mid-lesser trochanter level (T), and 20 mm blow it (T-20), and canal flare index (CFI), femoral cortical index (FCI) were measured on X-ray and CT images with PACS by two independent doctors. Data was analyzed by SPSS 20. Kolmogorov-Smirnov test was used to test data normality. Student's t-test was performed between PWH and control group. p < 0.05 was considered statistically significant. Among the 94 hips, 39 (41.5%) were included in group hemophilia and 55(58.5%) in control group. The mean age of the patients was 49.36 ± 12.92 years. All cases were male patients. Data demonstrated significantly smaller femoral cortical index (FCI), femoral offset, medullary cavity of 20 mm above mid-lesser trochanter level, mid-lesser trochanter level, and 20 mm below it, and neck-shaft angle (NSA) was obviously larger in PWH than control group (p < 0.05). No significant difference was found in canal flare index (CFI). Hemophilic patients undergoing THA were prone to longer and thinner proximal femur. Preoperative morphological analysis of femur is recommended.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Subventions
Organisme : Zhejiang Provincial Natural Science Foundation of China
ID : LD22C060002
Organisme : Zhejiang Traditional Chinese Medicine Administration
ID : 2023ZL369
Organisme : Project of Chunyan Special Fund for Chinese Medicine Development of Zhejiang Chinese Medical University
ID : CY202305
Informations de copyright
© 2024 The Authors. Orthopaedic Surgery published by Tianjin Hospital and John Wiley & Sons Australia, Ltd.
Références
He BJ, Mao Q, Li J, Lv SJ, Tong P, Jin HT. Bilateral synchronous total hip arthroplasty for end-stage arthropathy in hemophilia a patients: a retrospective study. Med (Baltimore). 2022;101(27):e29667.
Srivastava A, Brewer AK, Mauser-Bunschoten EP, Key NS, Kitchen S, Llinas A, et al. Guidelines for the management of hemophilia. Haemophilia. 2013;19:e1-e47.
Gillinov Stephen M, Burroughs Patrick J, Moore Harold G, et al. Total hip arthroplasty in patients with classic hemophilia: a matched comparison of 90-day outcomes and 5-year implant survival. J Arthroplasty. 2022;37(7):1333-1337.
Rodriguez-Merchan EC, Valentino LA. Orthopedic disorders of the knee in hemophilia: a current concept review. World J Orthop. 2016;7:370-375.
Livnat T, Budnik I, Levy-Mendelovich S, Avishai E, Misgav M, Barg AA, et al. Combination of hemostatic therapies for treatment of patients with hemophilia a and inhibitors. Blood Cells Mol Dis. 2017;66:1-5.
Ezio Z. Acquired hemophilia a: an update on the Etiopathogenesis, diagnosis, and treatment. Diagnostics (Basel). 2023;13(3):undefined.
Parsa A, Azizbaig Mohajer M, Mirzaie M. Hip arthroplasty in haemophilia: a systematic review. Hip Int. 2018;28:459-467.
Lee SH, Rhyu KH, Cho YJ, Yoo MC, Chun YS. Cementless total hip arthroplasty for haemophilic arthropathy: follow-up result of more than 10 years. Haemophilia. 2015;21:e54-e58.
Wu GL, Zhai JL, Feng B, Bian YY, Xu C, Weng XS. Total hip arthroplasty in hemophilia patients: a mid-term to long-term follow-up. Orthop Surg. 2017;9:359-364.
Tateiwa T, Takahashi Y, Ishida T, Kubo K, Masaoka T, Shishido T, et al. Perioperative management of hemophilia patients receiving total hip and knee arthroplasty: a complication report of two cases. Ther Clin Risk Manag. 2015;11:1383-1389.
Varnum C. Outcomes of different bearings in total hip arthroplasty - implant survival, revision causes, and patient-reported outcome. Dan Med J. 2017;64: B5350-B5351.
Thiesen Darius M, Dimitris N, Alexander K, et al. A comparison between Asians and Caucasians in the dimensions of the femoral isthmus based on a 3D-CT analysis of 1189 adult femurs. Eur J Trauma Emerg Surg. 2022;48:2379-2386.
Sun J, Zhang R, Liu S, Zhao Y, Mao G, Bian W. Biomechanical characteristics of the femoral isthmus during Total hip arthroplasty in patients with adult osteoporosis and developmental dysplasia of the hip: a finite element analysis. Orthop Surg. 2022;14(11):3019-3027.
Figen S-K, Kara ME. Canal flare index in the canine femur is influenced by the measurement method. Vet Comp Orthop Traumatol. 2020;33(3):198-204.
Sidler-Maier CC, Waddell JP. (2015) incidence and predisposing factors of periprosthetic proximal femoral fractures: a literature review. Int Orthop. 2015;39(9):1673-1682.
Konow T, Baetz J, Melsheimer O, Grimberg A, Morlock M. Factors influencing periprosthetic. Femoral fracture risk. Bone Joint J. 2021;103-B(4):650-658.
Robert F, Wagstaff Paul D, Ismaily Sabir K, et al. The length of Diaphyseal contact of tapered fluted stems is highly dependent on canal morphology. J Arthroplasty. 2022;37:S697-S702.
Ollivier M, Parratte S, Le Corroller T, Reggiori A, Champsaur P, Argenson JN. Anatomy of the proximal femur at the time of total hip arthroplasty is a matter of morphotype and etiology but not gender. Surg Radiol Anat. 2015;37(4):377-384.
Sakalkale DP, Sharkey PF, Eng K, Hozack WJ, Rothman RH. Effect of femoral component offset on polyethylene wear in total hip arthroplasty. Clin Orthop Relat Res. 2001;11:125-134.
Cassidy KA, Noticewala MS, Macaulay W, Lee JH, Geller JA. Effect of femoral offset on pain and function after total hip arthroplasty. J Arthroplasty. 2012;27:1863-1869.
Sariali E, Klouche S, Mouttet A, Pascal-Moussellard H. (2014) the effect of femoral offset modification on gait after total hip arthroplasty. Acta Orthop. 2014;85:123-127.
Laine HJ, Lehto MU, Moilanen T. Diversity of proximal femoral medullar canal. J Arthroplasty. 2000;15(1):86-92.
Dorr LD. Total hip replacement using APR system[J]. Tech Orthop. 1986;1:22-34.
Yeung Y, Chiu KY, Yau WP, Tang WM, Cheung WY, Ng TP. Assessment of the proximal femoral morphology using plain radiograph- can it predict the bone quality. Art Ther. 2006;21:508-513.
Ahlborg HG, Johnell O, Karlsson MK. An age-related medullary expansion can have implications for the long-term fixation of hip prosthesis. Acta Orthop Scand. 2004;75:154-159.
Wu D, Shen S. Osteoporosis and associated risk factors in patients with severe hemophilia a: a case-control study from China. BMC Musculoskeletal Disorder. 2023;24(1):657.
Lonner JH, Klotz M, Levitz C, Lotke PA. Changes in bone density after cemented total knee arthroplasty: influence of stem design. J Arthroplasty. 2001;16:107-111.