scholarly journals Total Hip Arthroplasty for Rapidly Destructive Coxarthrosis in a Patient with Severe Platelet Deficiency due to Liver Cirrhosis and Immune Thrombocytopenic Purpura

2015 ◽  
Vol 2015 ◽  
pp. 1-4
Author(s):  
Shunpei Hama ◽  
Fumiaki Inori ◽  
Dai Momose ◽  
Sadahiko Konishi
Keyword(s):  
Liver Cirrhosis ◽  
Platelet Count ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Immune Thrombocytopenic Purpura ◽  
Elderly Women ◽  
Thrombocytopenic Purpura ◽  
Total Hip ◽  
Low Platelet Count ◽  
Rapidly Destructive Coxarthrosis

Rapidly destructive coxarthrosis (RDC) causes rapid and extreme destruction of the hip joint, which was reported by Postel and Kerboull. RDC is commonly unilateral and occurs mostly in elderly women. Immune thrombocytopenic purpura (ITP) is characterized by a low platelet count that is the result of both immune-mediated platelet destruction and suppression of platelet production. In patients with ITP undergoing surgery, bleeding associated with a low preoperative platelet count can lead to unsuccessful outcomes. To the best of our knowledge, there has been only one report describing total hip arthroplasty (THA) for patients with ITP and there have been no reports of THA for RDC with a very low platelet count due to liver cirrhosis (LC) and ITP. We report the case of a patient who had right RDC and a very low platelet count due to LC and ITP in whom THA was successfully performed. Furthermore, this case was also unique in that her platelet count increased after THA. THA for right RDC might resolve ITP by relieving inflammation of the right hip since her platelet count recovered after THA.

scholarly journals Successful Treatment of Total Hip Arthroplasty to a Patient Associated with Alcoholic Cirrhosis and Severe Plated Deficiency with Preoperative Partial Splenic Embolization

2018 ◽  
Vol 12 (1) ◽  
pp. 445-450
Author(s):  
Yasuhiro Yamanaka ◽  
Hiroaki Nakano ◽  
Hiroshi Nakayama ◽  
Junichiro Okumura
Keyword(s):  
Platelet Count ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Successful Treatment ◽  
Alcoholic Cirrhosis ◽  
Direct Anterior Approach ◽  
Partial Splenic Embolization ◽  
Portal Vein Pressure ◽  
Total Hip ◽  
Splenic Embolization

Introduction: We present the first report of the successful treatment of Total Hip Arthroplasty (THA) to a patient associated with alcoholic cirrhosis and plated deficiency undergoing preoperative Partial Splenic Embolization. Case Report: A 45-year woman who had Liver Cirrhosis (LC) and alcohol residue heritage failure suffered from severe groin pain and had a difficulty in walking for a long period due to avascular necrosis of bilateral femoral head. She was referred to our orthopaedic service and THA was planned. Despite preoperative transfusion for her platelet deficiency coursed by LC, preoperative platelet count decreased less than a normal range. Therefore, Partial Splenic Embolization (PSE) was applied to her so as to increase platelet count. PSE could temporally reduce the portal vein pressure and prevent a hyperspleism and cytopenia. After the procedure, THA was performed to bilateral hip safely through a direct anterior approach. At the time of the latest follow-up, the patient had an excellent clinical result. Conclusion: Preoperative PSE may be a useful procedure to the patients with LC and severe plated deficiency who need arthroplasty including THA. Pre-existing physical and psychological factors have an effect on the outcome of arthroplasty and appropriate strategies might be needed.

Total Hip Arthroplasty in Patients with Coagulopathy

2019 ◽  
Vol 158 (02) ◽  
pp. 165-169
Author(s):  
Philipp von Roth ◽  
Kathi Thiele
Keyword(s):  
Liver Cirrhosis ◽  
Total Hip Arthroplasty ◽  
Blood Coagulation ◽  
Patient Group ◽  
Hip Arthroplasty ◽  
Surgical Intervention ◽  
Haemophilia A ◽  
Coagulation Disorders ◽  
Total Hip ◽  
Coagulation Status

AbstractPrior to a surgical intervention, the examination of patient coagulation disorders is unfortunately often underestimated. While patients with a haemophilia A or B are usually aware of the congenital tendency to bleed, disorders of increased blood coagulation, thrombophilia, are frequently undetected. Therefore, complications caused by thromboses and embolisms after total hip arthroplasty are far more common than uncontrollable post-operative bleeding. Patients with liver cirrhosis are considered to be particularly complicated and their coagulation status can be difficult to manage. This article describes the most common pathological coagulation disorders and provides information to identify them preoperatively. Furthermore, surgical strategy considerations for the use of certain implant types in this patient group are discussed.

scholarly journals Comparison of Acetabular Reamings during Hip Resurfacing versus Uncemented Total Hip Arthroplasty

2009 ◽  
Vol 17 (1) ◽  
pp. 42-46 ◽  
Author(s):  
SA Brennan ◽  
JA Harty ◽  
C Gormley ◽  
SK O'Rourke
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Elderly Women ◽  
Hip Resurfacing ◽  
Acetabular Cup ◽  
Total Hip ◽  
Uncemented Total Hip Arthroplasty ◽  
Neck Fracture ◽  
History Of ◽  
Resurfacing Hip Arthroplasty

Purpose. To compare the quantity of bone removed from the acetabulum during resurfacing hip arthroplasty versus uncemented total hip arthroplasty (THA). Methods. 62 consecutive patients with osteoarthritis of the hip were prospectively studied. 24 men and 7 women aged 40 to 86 (mean, 59) years underwent Birmingham hip resurfacing. 13 men and 18 women aged 34 to 88 (mean, 61) years underwent uncemented THA using the trident acetabular cup. Obese elderly women at risk of femoral neck fracture and patients with large subchondral pseudocysts or a history of avascular necrosis of the femoral head were assigned to uncemented THA. Acetabular reamings were collected; marginal osteophytes were not included. The reamings were dehydrated, defatted, and weighed. Results. The mean weight of acetabular reamings was not significantly different between patients undergoing hip resurfacing and uncemented THA (p=0.57). Conclusion. In hip resurfacing, the use of an appropriately small femoral component avoids oversizing the acetabular component and removal of excessive bone stock.

Total Hip Arthroplasty Using Kerboull-Type Acetabular Reinforcement Device for Rapidly Destructive Coxarthrosis

2010 ◽  
Vol 25 (3) ◽  
pp. 432-436 ◽  
Author(s):  
Toshiyuki Kawai ◽  
Chiaki Tanaka ◽  
Minoru Ikenaga ◽  
Hiroshi Kanoe ◽  
Shuzo Okudaira
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Total Hip ◽  
Rapidly Destructive Coxarthrosis ◽  
Reinforcement Device

scholarly journals Severe immune thrombocytopenic purpura after SARS-CoV-2 vaccine

2021 ◽  
Vol 8 (2) ◽  
pp. 31-36
Author(s):  
Katherine Cooper ◽  
Bradley Switzer
Keyword(s):  
Platelet Count ◽  
Immune Thrombocytopenic Purpura ◽  
Laboratory Tests ◽  
The United States ◽  
Severe Thrombocytopenia ◽  
Thrombocytopenic Purpura ◽  
Intravenous Immunoglobulin G ◽  
Response Prompting ◽  
Low Platelet Count ◽  
Work Up

Immune thrombocytopenic purpura (ITP) is a rare hematologic condition through to affect 3.3 in 100,000 adults per year in the United States. Many cases of immune thrombocytopenia are diagnosed incidentally with laboratory tests that reveal low platelet count, without a clear cause. However, when platelet counts are very low, patients may show signs of bleeding. Here we present the case of a 24-year-old female with mucocutaneous bleeding ten days after receiving her first dose of SARS-CoV-2 vaccine, who was subsequently found to have severe thrombocytopenia. Extensive work up for new thrombocytopenia was unremarkable suggesting a diagnosis of ITP, potentially secondary to vaccination. Empiric treatment with glucocorticoids was initiated without response prompting the use of intravenous immunoglobulin G. The patient was discharged on hospital day five with a platelet count over 20,000 platelets per microliter. In summary, ITP is a potential sequela of the SARS-CoV-2 vaccine, and otherwise healthy young individuals may be at risk for hematologic side effects.

scholarly journals Severe Immune Thrombocytopenic Purpura Treated with Plasma Exchange

2012 ◽  
Vol 10 (1) ◽  
pp. 77-82 ◽  
Author(s):  
MR Sigdel ◽  
DS Shah ◽  
MP Kafle ◽  
KB Raut
Keyword(s):  
Platelet Count ◽  
Plasma Exchange ◽  
Immune Thrombocytopenic Purpura ◽  
Low Dose ◽  
High Dose ◽  
Severe Thrombocytopenia ◽  
First Line ◽  
Thrombocytopenic Purpura ◽  
Steroid Resistant ◽  
Low Platelet Count

Immune thrombocytopenic purpura (ITP) is a hematological disorder characterized by immunologically mediated destruction of platelets and absence of other causes of thrombocytopenia. Treatment is required when the low platelet count entails risk of serious bleeding. Steroid is the first line of management. Acute refractory ITP with very low platelet count is variably treated with high dose steroid, intravenous immunoglobulin (IVIg), anti D or emergency splenectomy. Here, we present a case of steroid resistant ITP with severe thrombocytopenia treated with plasma exchange and low dose IVIg who responded dramatically to the therapy with maintained platelet count till one month from the institution of therapy. KATHMANDU UNIVERSITY MEDICAL JOURNAL  VOL.10 | NO. 1 | ISSUE 37 | JAN - MAR 2012 | 85-87 DOI: http://dx.doi.org/10.3126/kumj.v10i1.6922

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