Total Hip Arthroplasty in Patients with Coagulopathy

Prior 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.