Although knees, ankles and elbows are the top three joints for chronic bleeds, hips can also take a hit. As men with hemophilia age, some will need hip-replacement surgery. Now that there are more types of materials in use for hip replacement parts, the American Academy of Orthopaedic Surgeons (AAOS) has data to show which ones last longer and are stronger.
• Ceramic-on-ceramic surfaces have been used for about 20 years in the US. They don’t wear out and there’s a low risk of osteolysis (debris from the parts triggering an immune response, which can cause loosening).
• Metal-on-metal surfaces can increase metal ion levels in the blood and cause cobalt toxicity, a condition called metallosis. Some patients experienced bone damage at the hip joint.
• Highly cross-linked polyethylene surfaces have stood the test of time. There has been a low incidence of revisions (follow-up surgery) and dislocations with these.