Total Hip Replacement Arthroplasty in Patient with Idiopathic Thrombocytopenic Purpura: Clinical Experience of Perioperative Management

ABSTRACT

PURPOSE: Patients with idiopathic thrombocytopenic purpura (ITP) survive longer now than in the past, secondary to the development of more effective treatment modalities. The risk of osteonecrosis of the femoral head was known to be increased in these patients in the past. However, until now, there has been no issuance of definite guidelines concerning the perioperative management of patients with ITP undergoing arthroplasty of the hip. We analyzed the outcomes of hip arthroplasty in patients with ITP who received appropriate perioperative hematologic management. MATERIALS AND METHODS: Five patients (six cases) with the diagnoses of osteonecrosis of the femoral head and ITP underwent total hip arthroplasty between November 2001 and January 2004. Perioperatively, their hematologic profiles were evaluated, and appropriate management was undertaken, including transfusion. RESULTS: Total hip arthroplasty in patients with ITP was successful in spite of the risks of perioperative bleeding and infection. CONCLUSION: We recommend total hip arthroplasty in patients with thrombocytopenic disorders like ITP, as long as they are provided with appropriate perioperative hematologic management.