Total knee arthroplasty in hemophilia A

Pathak, Neil; Munger, Alana M.; Charifa, Ahmad; Laskin, William B.; Bisson, Emily; Kupfer, Gary M.; Rubin, Lee E.

doi:10.1016/j.artd.2019.12.008

Cited by 10 publications

(6 citation statements)

References 29 publications

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“…Extensive bleeding occurs in roughly 50% of haemophilic individuals undergoing THA or total knee arthroplasty with low-molecular-weight heparin. Regardless of prophylaxis, 39.1% of haemophilic patients undergoing total joint arthroplasty experience significant bleeding [ 18 ]. IPCDs and early ambulation are two other non-pharmacologic DVT prevention methods.…”

Section: Discussionmentioning

confidence: 99%

Total Hip Replacement in Severe Haemophilia A: Challenges and Feasibility

Bhattacharjee¹,

Naim²

2022

Cureus

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The management of haemophilic patients is complicated due to multiple comorbidities. A dedicated haemophilia treatment centre with a multidisciplinary team can plan and execute elective orthopaedic surgery in such haemophilic individuals.A cementless total hip arthroplasty (THA) was performed in a 26-year-old male patient with haemophilic arthropathy of the right hip under factor VIII replacement therapy based on activated partial thromboplastin time levels. The patient received a preoperative dose of recombinant anti-haemophilic factor. Venous thromboembolic event prophylaxis was not given. Postoperative radiographs demonstrated successful prosthesis placement. The patient could bear weight and walk unassisted two weeks after surgery.THA in patients with haemophilia leads to significant improvement in joint function with a relatively low incidence of complications with modern techniques and haematological management.

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Section: Discussionmentioning

confidence: 99%

Total Hip Replacement in Severe Haemophilia A: Challenges and Feasibility

Bhattacharjee¹,

Naim²

2022

Cureus

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“…Vascular injuries within the knee joint can also result in recurrent hemarthrosis. These include injuries to the superior and inferior lateral geniculate arteries, bleeding from arterial branches of the knee, arterio-arterial, or arterio-venous fistulae, pseudoaneurysms, or erosion of the femoral component through a hypertrophied atherosclerotic artery [ [11] , [12] , [13] , [14] ]. Risk factors for vascular malformations include previous complex surgeries, soft-tissue compromise, vascular diseases, and medical factors such as atherosclerosis, hypertension, and diabetes mellitus.…”

Section: Discussionmentioning

confidence: 99%

Recurrent Hemarthrosis After Total Knee Arthroplasty

2021

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Recurrent hemarthrosis is a rare complication after total knee arthroplasty (TKA). Its incidence is reported as less than 1%. Most patients present with acute knee pain and swelling in the absence of trauma, resulting in significant loss of function. The authors report a case of recurrent hemarthrosis in a 64-year-old female. She presented with repeated episodes of sudden-onset right knee pain, swelling, and bruising at 18 months after a right TKA. During revision knee surgery, the recurrent hemarthrosis was identified to have been caused by entrapment of hypertrophied knee synovium under the TKA tibial base plate. After excision of the synovial tissue and cementing of the tibial defect, the patient recovered well after surgery with no future recurrences of knee pain and swelling.

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“…Postoperative bleeding is a common complication of TKA in the hemophilic population. Administration of clotting factors and tranexamic acid (TXA) is proven to be effective to decrease blood loss and should therefore be administrated (24,52,53,54). In addition, the authors recommend the use of topical TXA.…”

Section: Perioperative Challenges In Primary Tka In Patients With Hamentioning

confidence: 99%

Primary total knee arthroplasty in hemophilic arthropathy

Beckers,

Massé,

Vendittoli

et al. 2023

EFORT Open Reviews

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Advanced hemophilic knee arthropathy is a frequent and devastating manifestation of severe hemophilia with significant implications for activities of daily living. Hemophilic arthropathy is caused by repeated bleeding, resulting in joint degeneration, pain, deformity and disability. In patients with hemophilia and advanced disease, total knee arthroplasty (TKA) has proven to be the most successful intervention, improves physical function and reduces knee pain. Hemophilic patients carry additional risks for complications and required specific pre/postoperative considerations. Expert treatment center should be used to improve patient outcome. Hemophilic patients present significant surgical challenges such as joint destruction, bone loss, severe ankylosis and oligoarticular involvement. The surgeon performing the arthroplasty must be experienced to manage such problems.

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Total knee arthroplasty in hemophilia A

Cited by 10 publications

References 29 publications

Total Hip Replacement in Severe Haemophilia A: Challenges and Feasibility

Total Hip Replacement in Severe Haemophilia A: Challenges and Feasibility

Recurrent Hemarthrosis After Total Knee Arthroplasty

Primary total knee arthroplasty in hemophilic arthropathy

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