Perioperative anaesthesia and coagulation management of haemophilia patients receiving total hip and knee replacement arthroplasty: Experience from a case series

• Main Authors: Sibei Li, Bo Qu, Wuhua Ma, Yuhui Li
• Format: Article
• Language: English
• Published: SAGE Publishing 2019-09-01
• Series: Journal of Orthopaedic Surgery
• Online Access: https://doi.org/10.1177/2309499019874931

Purpose: To report 13 consecutive cases of successful triad of anaesthesia, blood and coagulation management (ABC protocol) in haemophilic total joint arthroplasty (TJA) and its feasibility and safety on haemophilic TJA. Methods: All the clinical data of 13 consecutive cases were descend from electronic medical record. Patients who suffered from haemophilia A, undergoing primary total hip arthroplasty (THA) or total knee arthroplasty (TKA) with ABC protocol at the academic hospital from December 2014 to November 2018 were included, and demographic, perioperative characteristics according to the classified method were further analysed. Results: All 13 haemophilic patients had undergone successful surgery with ABC protocol. No massive blood loss was observed in perioperative period. The mean external blood loss was 876.92 ± 592.86 mL. The mean change in haemoglobin was 5.42 ± 2.43 g dL −1 at 5 days post-operatively. The mean allogeneic transfusion volume was 1.23 ± 1.35 units, and the mean volume of autotransfusion was 237.5 ± 76.93 mL. The average clotting factor consumption for per operated joint was 458.26 ± 226.45 IU kg −1 in all cases. No severe perioperative complications were occurred. Conclusion: ABC-related series of measures were appropriate management mode for patients received THA and/or TKA with mild or moderate haemophilia. However, more robust evidence came from larger samples is needed.