Peri-operative treatment for total hip replacement in patients with hepatic cirrhosis

doi:10.3969/j.issn.2095-4344.2013.52.005

Abstract

Abstract:

BACKGROUND: Hepatic cirrhosis may adversely affect the outcome of major orthopedic surgery, such as total hip arthroplasty. Peri-operative treatment is the challenge for all orthopedic surgeons.
OBJECTIVE: To analyze the safety and feasibility of hip replacement surgeries in patients with hepatic cirrhosis.
METHODS: Thirteen patients with hepatic cirrhosis that underwent hip replacement were retrospectively analyzed to evaluate the treatments and their efficacy before and after replacement.
RESULTS AND CONCLUSION: All 13 surgeries were successfully performed. All cases were followed up for more than five months and were graded according to Child-Pugh Criteria for hepatic functional reserve preoperatively and postoperatively. Five cases of the seven preoperative grade A cases preserved grade A postoperatively during a two-week observation, while another two cases rose to grade B and needed hepatic conservation treatment before discharge. Two cases of the six preoperative grade B cases rose to grade C with developed jaundice and ascites. Of the two, one even suffered a complication of upper gastrointestinal hemorrhage 5 days after surgery. Somatostatin and proton pump inhibitors were administered to stop bleeding. All cases gained a satisfying recovery. Harris hip score at follow-up showed favorable hip function. Hip replacement is safe and feasible for patients with hepatic cirrhosis when full evaluation of hepatic function and appropriate perioperative management are ensured.

中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程

全文链接：

Key words: hepatic cirrhosis, arthroplasty, replacement, hepatic inadequacy, albumin

CLC Number:

R318

Xu Jie, Huang Jing, Ma Ruo-fan, Li Deng, Cai Zhi-qing, Li Liang-ping. Peri-operative treatment for total hip replacement in patients with hepatic cirrhosis[J]. Chinese Journal of Tissue Engineering Research, 2013, 17(52): 8967-8973.

Figures/Tables 3

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