• Decheng Meng, Runzi Zhang, Chenni Ji, Shijun Gao, and Juan Wang.
• Department of Joint Surgery, The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, China.
• Medicine (Baltimore). 2022 Nov 18; 101 (46): e31644e31644.

RationaleCongenital dysfibrinogenemia (CD) is a rare coagulation system disease that is often treated without unified management. Individualized treatment thereof presents clinicians with great challenges.Patient ConcernsA patient who was about to undergo total knee arthroplasty was found to have CD.DiagnosesCoagulation screening revealed low fibrinogen, prolonged thrombin time, minor prolonged prothrombin time, and normal activated partial thromboplastin time were detected during admission, but no abnormal personal and family history findings were observed. Therefore, CD and hypofibrinogenemia were suspected. The gene sequencing confirmed the diagnosis of CD.InterventionsThe patient received plenty and low level of fibrinogen concentrate during 2 perioperative periods, respectively.OutcomesSuccessful clinical outcomes were obtained using different treatment strategies.LessonsIn contrast to prior case reports, this case illustrates the feasibility of low dosing of fibrinogen supplements within an asymptomatic patient in a selective operation. Changes in the level of fibrinogen and fibrin degradation product are of great importance for individualized treatment after supplementation.Copyright © 2022 the Author(s). Published by Wolters Kluwer Health, Inc.

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