Email this article Total hip arthroplasty in patients with Gaucher disease: characteristics and outcomes
- Authors: Mamonov V.E.1, Chabaeva Y.A.1, Khomenko V.A.1, Ponomarev R.V.1, Lukina E.A.1
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Affiliations:
- National Medical Research Center for Hematology
- Issue: Vol 32, No 2 (2025)
- Pages: 347-359
- Section: Original study articles
- URL: https://ogarev-online.ru/0869-8678/article/view/314743
- DOI: https://doi.org/10.17816/vto634044
- EDN: https://elibrary.ru/PGDEQN
- ID: 314743
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Abstract
BACKGROUND: Avascular necrosis of the femoral head (ANFH) is the indication for total hip arthroplasty (THA) in patients with Gaucher disease (GD). Due to the rarity of GD, the surgical procedure and long-term outcomes in large patient populations have been insufficiently studied.
AIM: This study aimed to analyze the perioperative period as well as medium- and long-term outcomes of THA in patients with GD.
METHODS: A retrospective, single-center study was conducted in 26 patients with GD who underwent 30 primary THAs and 9 revision hip arthroplasties between 2005 and 2023.
RESULTS: Good and excellent THA outcomes were achieved in 87% of cases, with follow-up periods ranging from 1 to 10 years (median: 7 years). Unsatisfactory results during the 10-year follow-up were due to periprosthetic infection (2 cases) and aseptic loosening (3 cases). Both cases of periprosthetic infection were caused by osteoarticular tuberculosis, which was not detected at the prehospital stage. High intraoperative blood loss was associated with the duration of enzyme replacement therapy (ERT). Blood loss of >1000 mL was reported in 57%, 22%, and 0% of surgeries when ERT lasted less than 5 years, 5–10 years, and more than 10 years, respectively (p = 0.047). Implant survival without revision 3, 6, and 12 years post-surgery was 97%, 93%, and 61%, respectively. At 12 years, the survival rates for cemented and uncemented implants without revision were 33% and 67%, respectively. Twelve years post-surgery, implant survival without revision was 43% for the CoCr/PE bearing surface and 83% for other combinations (ceramic/ceramic, ceramic/PE, and modified metal / PE).
CONCLUSION: THA improves quality of life in patients with GD after ANFH. Uncemented implants with ceramic-on-ceramic, ceramic-on-polyethylene, or modified metal-on-polyethylene bearings demonstrated greater longevity and lower revision rates. A high risk of perioperative hemorrhagic complications was observed in patients who received ERT for less than 5 years. The risk of periprosthetic infection was 6.7%, and tuberculosis should be ruled out in such cases.
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##article.viewOnOriginalSite##About the authors
Vasily E. Mamonov
National Medical Research Center for Hematology
Author for correspondence.
Email: vasily-mamonov@yandex.ru
ORCID iD: 0000-0001-7795-4564
SPIN-code: 1773-9159
MD, Cand. Sci. (Medicine)
Russian Federation, 4 Novy Zykovsky proezd, Moscow, 125167Yulya A. Chabaeva
National Medical Research Center for Hematology
Email: uchabaeva@gmail.com
ORCID iD: 0000-0001-8044-598X
SPIN-code: 3314-7674
MD, Cand. Sci. (Engeneering)
Russian Federation, 4 Novy Zykovsky proezd, Moscow, 125167Vladimir A. Khomenko
National Medical Research Center for Hematology
Email: khomenkov@mail.ru
ORCID iD: 0000-0001-8988-556X
SPIN-code: 7192-9639
MD, Dr. Sci. (Medicine), Professor
Russian Federation, 4 Novy Zykovsky proezd, Moscow, 125167Rodion V. Ponomarev
National Medical Research Center for Hematology
Email: ponomarev.r.v@icloud.com
ORCID iD: 0000-0002-1218-0796
SPIN-code: 1618-7375
MD, Cand. Sci. (Medicine)
Russian Federation, 4 Novy Zykovsky proezd, Moscow, 125167Elena A. Lukina
National Medical Research Center for Hematology
Email: elenalukina02@gmail.com
ORCID iD: 0000-0002-8774-850X
SPIN-code: 7829-5794
MD, Dr. Sci. (Medicine), Professor
Russian Federation, 4 Novy Zykovsky proezd, Moscow, 125167References
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