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Orthopaedic outcome of total knee replacement in Haemophilia A
Author(s) -
Israel Cohen,
Michael Heim,
Uri Martinowitz,
A Chechick
Publication year - 2000
Publication title -
haemophilia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.213
H-Index - 92
eISSN - 1365-2516
pISSN - 1351-8216
DOI - 10.1046/j.1365-2516.2000.00375.x
Subject(s) - medicine , haemophilia , surgery , fibrin glue , arthrodesis , total knee replacement , arthropathy , knee replacement , prosthesis , arthroplasty , osteoarthritis , alternative medicine , pathology
A consecutive series of 16 patients with classical Haemophilia underwent 21 total knee replacements between 1989 and 1997 for haemophilic arthropathy. The patients received Factor VIII replacement therapy via continuous infusion, and fibrin glue was used to facilitate haemostasis. Three different types of prostheses were used. A follow‐up evaluation was undertaken between 2 and 10 years after the operation (mean 5.6 years) and two patients with infection were excluded. Knee scores averaged 77.5 (pre‐operative 24.1) and functional scores averaged 84.4 (preoperative 23.2). There were no cases with aseptic loosening of the prosthesis. Complications included one early deep infection controlled by conversion of the TKR into an arthrodesis, one case of late septic loosening that had to be re‐operated upon, one case of patellar dislocation, two cases of stiff knee (fibro‐arthrosis) that required manipulation under anaesthesia, one postoperative hepatitis, one superficial infection treated by incision and drainage and four febrile patients with no clear source of infection, who responded to antibiotics alone. In conclusion, TKR offers haemophilic patients a long‐lasting improvement of their quality of life and we therefore advocate its use with the appropriate indications.