Special features of total knee replacement in hemophilia.
Total knee replacement is an operation frequently needed by hemophilia patients, which greatly improves their quality of life. This operation, however, carries a higher risk of bleeding and infection for hemophiliacs than it does for osteoarthritis sufferers. It is advisable to implant prosthetic components using antibiotic-loaded cement. It is essential to maintain a level of 100% of the replacement clotting factor for 2 weeks. Hematological treatment must be established, depending on the patient's factor levels and other pharmacokinetic parameters such as recovery and half-life, optimal doses and treatment time. It is preferable to use general anesthesia due to the risk of spinal bleeding. The lifespan of total knee replacement in hemophilic patients is shorter than in patients with osteoarthritis because of the increased risk of infection.
Department of Orthopaedic Surgery, La Paz University Hospital, Paseo de la Castellana 261, 28046-Madrid, Spain and Autonomous University, School of Medicine, Madrid, Spain ecrmerchan@gmx.es.
Emerito Carlos
EC
Rodriguez-Merchan
D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D019645:Arthroplasty, Replacement, Knee; D001424:Bacterial Infections / Q000517:prevention & control; D005164:Factor IX / Q000008:administration & dosage; D005169:Factor VIII / Q000008:administration & dosage; D006467:Hemophilia A / Q000150:complications*; D006801:Humans; D007592:Joint Diseases / Q000150:complications / Q000601:surgery*; D007717:Knee / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D011300:Preoperative Care; D011859:Radiography; D012307:Risk Factors; D055815:Young Adult
D000900:Anti-Bacterial Agents; D005169:Factor VIII; D005164:Factor IX