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. 2022 Jul 11;23(1):31.
doi: 10.1186/s10195-022-00648-5.

Total knee arthroplasty in patients with haemophilic arthropathy is effective and safe according to the outcomes at a mid-term follow-up

Rui Wang #  1 , Zhengming Wang #  2   3 , Yong Gu  1 , Jingjing Zhang  1 , Penghe Wang  1 , Peijian Tong  4 , Shuaijie Lv  5
Affiliations

Total knee arthroplasty in patients with haemophilic arthropathy is effective and safe according to the outcomes at a mid-term follow-up

Rui Wang et al. J Orthop Traumatol. .

Abstract

Background: Haemophilic arthropathy (HA), a common complication of haemophilia, is secondary to recurrent joint bleeding and increases the prevalence of end-stage osteoarthritis (OA). Total knee arthroplasty (TKA) is a reliable treatment for haemophilia patients. This study was performed to evaluate the mid-term outcomes of TKA for end-stage HA. We hypothesized that the rate of complications of TKA is higher for patients with haemophilia than for patients without haemophilia.

Methods: Patients with HA undergoing TKA from January 2015 to December 2016 in our centre were retrospectively reviewed. All patients were managed by a multidisciplinary team. The improvements in flexion contracture, range of motion (ROM), Knee Society Score (KSS; clinical and functional), Visual Analogue Scale (VAS) score, and satisfaction at final follow-up were analysed to evaluate the effectiveness of TKA in HA. The complications were analysed to evaluate the safety of TKA in HA.

Results: Twenty-eight patients (32 knees) were included in the study. The follow-up was 69.1 ± 5.1 months. Significant differences between the preoperative and final follow-up values of flexion contracture (which changed from 21.1 ± 6.5° to 14.3 ± 4.1°, P < 0.001), ROM (from 53.9 ± 15.0° to 70.3 ± 16.3°, P < 0.001), clinical KSS (from 33.5 ± 14.4° to 62.7 ± 9.5°, P < 0.001), functional KSS (from 46.1 ± 15.5° to 62.9 ± 9.7°, P < 0.001), and VAS score (from 6.8 ± 1.4 to 4.9 ± 1.3, P < 0.01) were observed. Importantly, the incidence of complications was 15.6% and the satisfaction was 100% in our mid-term study.

Conclusion: Under elaborative and comprehensive management, TKA is effective and safe in patients with advanced HA on the basis of mid-term follow-up outcomes.

Keywords: Arthropathy; Haemophilia; Mid-term outcome; Total knee arthroplasty.

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Conflict of interest statement

The author(s) declare no potential competing interests in the research, authorship, and/or publication of this article.

Figures

Fig. 1
Fig. 1
Trend in the flexion contracture, with the results obtained preoperatively, at 6 and 24 months postoperatively, and at the final follow-up shown. Pre. preoperative; * P value < 0.05 versus the preoperative value
Fig. 2
Fig. 2
Trends in the clinical KSS and functional KSS, with the results obtained preoperatively, at 6 and 24 months postoperatively, and at the final follow-up shown. KSS Knee Society Score, Pre. preoperative
Fig. 3
Fig. 3
Trend in the ROM, with the results obtained preoperatively, at 6 and 24 months postoperatively, and at the final follow-up shown. ROM range of motion, Pre. preoperative; * P value < 0.05 versus the preoperative value
Fig. 4
Fig. 4
Trend in the VAS score, with the results obtained preoperatively, at 6 and 24 months postoperatively, and at the final follow-up shown. VAS visual analogue scale, Pre. preoperative
Fig. 5
Fig. 5
Radiographs of a 35-year-old male patient with severe haemophilic arthropathy. Preoperative X-rays showed extensive destruction of an articular surface, narrowing of the joint space, and a square patella. A Preoperative anteroposterior radiograph. B Preoperative lateral view. C Postoperative anteroposterior radiograph. D Postoperative lateral view. E Final follow-up anteroposterior radiograph. F Final follow-up lateral view
Fig. 6
Fig. 6
Clinical and radiographic views of both lower extremities. Postoperative X-rays showed a good position of the prosthesis and a good restoration of the force line of the right lower limb
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References

    1. O'Hara J, Walsh S, Camp C, Mazza G, Carroll L, Hoxer C, Wilkinson L. The impact of severe haemophilia and the presence of target joints on health-related quality-of-life. Health Qual Life Outcomes. 2018;16(1):84. doi: 10.1186/s12955-018-0908-9. - DOI - PMC - PubMed
    1. Iorio A, Stonebraker JS, Chambost H, Makris M, Coffin D, Herr C, Germini F. Establishing the prevalence and prevalence at birth of hemophilia in males: a meta-analytic approach using national registries. Ann Intern Med. 2019;171(8):540–546. doi: 10.7326/M19-1208. - DOI - PubMed
    1. Oladapo AO, Epstein JD, Williams E, Ito D, Gringeri A, Valentino LA. Health-related quality of life assessment in haemophilia patients on prophylaxis therapy: a systematic review of results from prospective clinical trials. Haemophilia. 2015;21(5):e344–e358. doi: 10.1111/hae.12759. - DOI - PubMed
    1. Sidonio RF, Mili FD, Li T, Miller CH, Hooper WC, DeBaun MR, Soucie M. Females with FVIII and FIX deficiency have reduced joint range of motion. Am J Hematol. 2014;89(8):831–836. doi: 10.1002/ajh.23754. - DOI - PMC - PubMed
    1. Anagnostis P, Karras S, Paschou SA, Goulis DG. Haemophilia A and B as a cause for secondary osteoporosis and increased fracture risk. Blood Coagul Fibrinolysis. 2015;26(6):599–603. doi: 10.1097/MBC.0000000000000330. - DOI - PubMed