Abstract
Introduction: Although previously published studies have documented a high perioperative risk in patients with liver failure undergoing major orthopedic surgery, little information is available on clinical outcomes following bilateral MIS-THA performed in a one-day session for this group of patients. Here, we report a patient with liver cirrhosis and idiopathic osteonecrosis of the hips treated by bilateral MIS-THA in a one-day session.
Case: A 64-year-old man with liver cirrhosis presented to our hospital with complaints of severe bilateral hip joint pain in 2011. Radiographic examinations and magnetic resonance imaging showed that the patient had bilateral idiopathic osteonecrosis (Stage IIIb, Type C-II). He underwent bilateral MIS-THA using bone cement in a one-day session in January 2012. The postoperative course was uneventful and after one year, he remains pain-free and is able to mobilize without walking aids.
Conclusion: In general, patients with cirrhosis have an increased risk of bleeding complications during MIS-THA because of underlying coagulopathy and thrombocytopenia. The present case showed the successful use of bone cement in MIS-THA for preventing postoperative bleeding in the patients with cirrhosis and also demonstrated that patients with Child-Pugh class-A cirrhosis may have a good clinical outcome following bilateral MIS-THA when performed in a one-day session.
