Total knee arthroplasty in HIV-positive haemophilic patients.
In the era of total joint replacements in orthopaedics, total knee arthroplasty (TKA) should be indicated in haemophilic patients suffering from severe knee pain and disability. However, the expected high risk of infection and other postoperative complications is a concern. Although the message of this article may seem conservative, it should not be inferred that TKA should still be avoided in a haemophilic patient, but rather that the orthopaedic surgeon should weigh the risks and benefits carefully. Clinical and immunological status should be considered before suggesting a total knee replacement to a haemophilic patient. If TKA is contraindicated, knee arthrodesis is the alternative. However, knee joint debridement can relieve pain for several years and delay the need for TKA.
Rodriguez-Merchan
E C
EC
Service of Traumatology and Orthopaedics, and Haemophilia Centre, La Paz University Hospital, Madrid, Spain. rmerchan@arrakis.es
Wiedel
J D
JD
D000163:Acquired Immunodeficiency Syndrome / Q000150:complications / Q000628:therapy*; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects / Q000706:statistics & numerical data; D006395:Hemarthrosis / Q000209:etiology / Q000517:prevention & control / Q000601:surgery; D006467:Hemophilia A / Q000150:complications* / Q000628:therapy / Q000821:virology; D006801:Humans; D016896:Treatment Outcome