ABSTRACT
Objective: To analyze the clinical features of the patient with myelodysplastic syndrome who developed bilateral ischemia necrosis of femoral head after allogeneic hematopoietic stem cell transplantation, and to discuss the perioperative management, efficacy and prognosis of bilateral hip arthroplasty for such patients. Methods: The clinical material of one patient with myelodysplastic syndrome who developed bilateral ischemia necrosis of femoral head after allogeneic hematopoietic stem cell transplantation including age, gender, clinical symptoms, previous medical history and outcomes, auxiliary examinations, treatment regimen and prognosis were collected, and the relevant literatures were reviewed. Results: After allogeneic hematopoietic stem cell transplantation, the patient was diagnosed with bilateral ischemia necrosis of femoral head (Ficat stage: left stage IV, right stage IE); the patient presented bilateral hip joint pain and severe limitation of movement. Admission to complete preoperative examination, through multiple consultations of Department of Hematology (blood routine, coagulation routine, erythrocyte sedimentation rate, cyclosporine concentration) and Department of Anesthesiology (blood routine, coagulation routine, liver and kidney function, cardiopulmonary function and lower extremity venous color Doppler), bilateral total hip arthroplasty was decided to perform. The operation went on smoothly, the patient recovered quickly after operation, and the symptoms of pain were improved significantly. The first day after operation, the patient went to the ground, and walked with two crutches. There was no complications during perioperative period and postoperation. One month after operation, the patient recovered well, blood routine examination, liver function, renal function, erythrocyte sedimentation rate, C-reactive protein and pelvic positivity were all normal. Conclusion: Total hip arthroplasty is effective in the patients with bilateral ischemia necrosis of femoral head after allogeneic hematopoietic stem cell transplantation. Strengthening perioperative management can effectively prevent the complications and improve the quality of life of the patients.