Marta Santos Silva1, Ricardo Rodrigues-Pinto1,2,3,4, Cláudia Rodrigues1, Sara Morais5, José Costa E Castro1,2. 1. 1 Department of Orthopaedics, Centro Hospitalar do Porto - Hospital de Santo António, Porto, Portugal. 2. 2 ICBAS - Instituto de Ciências Biomédicas Abel Salazar, Porto, Portugal. 3. 3 Trofa Saúde Hospital Privado de Alfena, Alfena, Portugal. 4. 4 Trofa Saúde Hospital Privado Braga Centro, Braga, Portugal. 5. 5 Department of Hematology, Centro Hospitalar do Porto - Hospital de Santo António, Porto, Portugal.
Abstract
PURPOSE: Knee arthropathy is a frequent complication affecting hemophilic patients, which can cause severe pain and disability. When conservative measures fail, total knee arthroplasty (TKA) may be performed. METHODS: Eighteen TKA were performed in 15 patients with hemophilia during a 24-year period in a Hemophilia Comprehensive Care Center. All patients were evaluated by a multidisciplinary team constituted by a hematologist, an orthopedic surgeon, and a physical medicine and rehabilitation physician. Mean follow-up was 11.3 years. RESULTS: Ten-year survival rate with prosthesis removal as end point was 94.3%. At last, follow-up visual analog pain scale score was 3.2 points, knee osteoarthritis outcome scale was 86.7 points, and mean range of motion was 88°. Only two patients required perioperative transfusion. Complication rate was 27.8% and included two infections, two prosthesis stiffness, and one case of recurrent hemarthrosis. CONCLUSION: After appropriate medical optimization and with prompt rehabilitation, TKA can be performed in hemophilic patients with good clinical results and survivor rates comparable to nonhemophilic patients.
PURPOSE:Knee arthropathy is a frequent complication affecting hemophilic patients, which can cause severe pain and disability. When conservative measures fail, total knee arthroplasty (TKA) may be performed. METHODS: Eighteen TKA were performed in 15 patients with hemophilia during a 24-year period in a Hemophilia Comprehensive Care Center. All patients were evaluated by a multidisciplinary team constituted by a hematologist, an orthopedic surgeon, and a physical medicine and rehabilitation physician. Mean follow-up was 11.3 years. RESULTS: Ten-year survival rate with prosthesis removal as end point was 94.3%. At last, follow-up visual analog pain scale score was 3.2 points, knee osteoarthritis outcome scale was 86.7 points, and mean range of motion was 88°. Only two patients required perioperative transfusion. Complication rate was 27.8% and included two infections, two prosthesis stiffness, and one case of recurrent hemarthrosis. CONCLUSION: After appropriate medical optimization and with prompt rehabilitation, TKA can be performed in hemophilic patients with good clinical results and survivor rates comparable to nonhemophilic patients.
Entities:
Keywords:
arthropathy; hemophilia; long-term results; total knee arthroplasty
Authors: Neil Pathak; Alana M Munger; Ahmad Charifa; William B Laskin; Emily Bisson; Gary M Kupfer; Lee E Rubin Journal: Arthroplast Today Date: 2020-03-06