Open AccessTotal knee replacement in patients with hemophilia with severe axial deformation and combined instability
Author(s) -
Б. В. Малюк,
М. А. Герасименко,
Oleg Eismont,
В. А. Змачинский,
А. Б. Деменцов
Publication year - 2020
Publication title -
vescì nacyânalʹnaj akadèmìì navuk belarusì. seryâ medycynskìh navuk
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.138
H-Index - 1
eISSN - 2524-2350
pISSN - 1814-6023
DOI - 10.29235/1814-6023-2020-17-2-191-202
Subject(s) - medicine , valgus , surgery , perioperative , knee joint , coagulation
We have analyzed results of treatment of 23 (30 knee joints) patients, including Hemophilia A – 22 cases (73.3 %) and Hemophilia B – 8 (26.7 %), with III–IV stages of hemophilic arthropathy, who were operated on for severe combined instability and various types of deformations: varus – 8, valgus – 11, recurvation – 2, “сompensated” valgus-varus – 3; totally 30 TKRs. In 7 patients (30.4 %) both knee joints were operated on. TKR of the right knee joint – 16 (53.3 %), left – 14 (46.7 %). With flexion contracture – 6 cases, mixed – 20, rigidity – 4. In 19 cases (63.3 %) deviation of the lower limb axis was >10°. We used: X-ray, topogram of lower extremities, CT. For coagulation status assessment we used: screening coagulation test, levels of scarce coagulation factors (FVIII, FIX), inhibitor of coagulation factor (FVIII, FIX) level. Function was evaluated before and at 1–9 years postoperatively using KSS, Oxford and VAS scales. Statistical analysis – STATISTICA 6.0, p 0.05). The developed tactics of hemostatic replacement therapy and laboratory control provided satisfactory hemostasis in the perioperative period.