Inherited thrombophilia may be a causative factor for osteonecrosis of femoral head in male patients with developmental dysplasia of the hip: a case series.

PURPOSE: The aim of this case series was to assess the effect of two common causes of inherited thrombophilia, factor V Leiden (FVL) and prothrombin mutation (PTM) on the development of osteonecrosis of the femoral head (ONFH) following the treatment of developmental dysplasia of the hip (DDH).

METHODS

FVL and PTM analysis of 58 patients (45 females and 13 males; mean age 12.2 years) with ONFH due to DDH treatment was done.

RESULTS

Rate of inherited thrombophilia (FVL plus PTM) was 15.5 %. Inherited thrombophilia was nearly four times higher in male patients than in female patients and this difference was mainly due to FVL (P < 0.05). This finding was against the common belief that, coagulation abnormalities were equally distributed across the sexes in normal population. Rates of overall inherited thrombophilia, FVL and PTM were not correlated with the type of ONFH (P > 0.05).

CONCLUSION

Hereditary thrombophilia, especially FVL, may be one of the causative factors for the development of ONFH following DDH treatment in male patients. Further prospective, controlled studies are needed to undoubtedly enlighten this issue.